机器人技术在微创治疗骨盆骨折中的未来发展

Future Development of Robotics in Minimally Invasive Treatment of Pelvic Fractures

摘要: 背景：机器人辅助骨盆骨折复位系统可以潜在地降低感染风险并改善预后，从而带来显著的健康和经济效益。然而，由于尚未解决的困难，这些系统仍处于实验室阶段，尚未准备好商业化。虽然以前的综述侧重于单个技术，系统组成和手术分期，但有必要进行全面的综述，以帮助未来的学者选择适合临床应用的研究方向。方法：使用PubMed检索机器人辅助骨盆骨折复位系统的相关文献。全面搜索“骨盆骨折复位”、“计算机辅助骨盆骨折手术”和“机器人辅助骨盆骨折复位”的结果分别为2222、196和32。选取了约200篇文章，通过对摘要的审阅，选取了10篇高度相关的文章进行深入阅读。结果和结论：螺钉固定在骨盆骨折治疗中的应用，使手术更加微创化，越来越多的辅助技术应用于微创螺钉置入。术前3D打印技术与骨科手术机器人辅助螺钉置入相结合是一种可行的创新辅助技术。通过术前3D打印规划，可以减少骨科手术机器人辅助手术术中螺钉绘制时间，降低螺钉绘制难度。这也使得手术中进入点的选择更有针对性。在不增加术中侵入性操作时间和透视次数的前提下，将术前3D打印技术与机器人完美结合，可以提高螺钉置入精度，实现良好的骨折固定，减少手术并发症。

Abstract: Background: Robot-assisted pelvic fracture reduction systems can potentially reduce the risk of infection and improve outcomes, leading to significant health and economic benefits. However, due to unresolved difficulties, these systems are still in the laboratory stage and not yet ready for commercialization. While previous reviews have focused on individual techniques, system composition, and surgical staging, a comprehensive review is necessary to help future scholars select research directions that are appropriate for clinical application. Methods: PubMed was used to search the relevant literature of robot-assisted pelvic fracture reduction system. A comprehensive search for “pelvic fracture reduction”, “computer-assisted pelvic fracture surgery” and “robot-assisted pelvic fracture reduction” yielded 2222, 196 and 32 results, respectively. About 200 articles were selected, and through a review of the abstract, 10 highly relevant articles were selected for in-depth reading. Results and Conclusions: The application of screw fixation in the treatment of pelvic fractures makes the surgery more minimally invasive, and more and more assistive techniques are applied to minimally invasive screw placement. Preoperative 3D printing technology combined with robot-assisted screw placement in orthopedic surgery is a feasible and innovative assistive technology. Preoperative 3D printing planning can reduce the time and difficulty of screw drawing in orthopedic robot-assisted surgery. This also makes the selection of entry points during surgery more targeted. Under the premise of not increasing the invasive operation time and fluoroscopy times during the operation, the perfect combination of preoperative 3D printing technology and robot can improve the screw placement accuracy, achieve good fracture fixation, and reduce surgical complications.