Comparison of Outcomes Following TiRobot-Assisted Sacroiliac Screw Fixation with Bone Grafting and Traditional Screw Fixation without Bone Grafting for Unstable Osteoporotic Sacral Fracture: A Single-Center Retrospective Study of 33 Patients

Abstract

Background This retrospective study from a single center aimed to compare patient outcomes following TiRobot-assisted sacroiliac screw fixation and bone grafting with traditional screw fixation without bone grafting in 33 patients with unstable osteoporotic sacral fracture (UOSF). Material/Methods Patients with UOSF were included and divided into 2 groups: a TiRobot-assisted surgical group with 18 patients (robot-aided sacroiliac screw fixation and bone grafting) and a standard surgical group with 15 patients (free-hand screw fixation without bone grafting). T values of bone mineral density (BMD) ≤-2.5 standard deviation (SD) were diagnosed as osteoporosis. Screw positioning and fracture healing time were evaluated. Functional outcomes were investigated at the final follow-up. Results There were no statistically significant differences in screw positioning; however, there were satisfactory positioning rates in 94.4% (17/18) of patients in the TiRobot-assisted surgical group and 73.3% (11/15) in the standard surgical group. The advantages with TiRobot on surgical time of screw placement, fluoroscopy frequency, and total drilling times were noted ( P =0.000). The nonunion rates were 5.6% (1/18) in the TiRobot-assisted surgical group and 33.3% (5/15) in the standard group ( P =0.039). Healing time in the union cases had a significant difference ( P =0.031). Functional outcome scores in the TiRobot-assisted surgical group were superior to that in the standard group ( P =0.014). Conclusions The findings showed that TiRobot-assisted sacroiliac screw fixation and bone grafting was a safe and effective surgical treatment option that had a reduced radiation dose and improved fracture healing, when compared with standard screw fixation without bone grafting.

Comparative Study of Triangular Osteosynthesis with and without Robotic Assistance for Unilateral Unstable Sacral Fractures Involving Lumbosacral Junction Injuries

“…According to recorded frequency of intraoperative uoroscopy, the data in this study were signi cantly decreased in the robot group (P < 0.001), which was similar to the existing reports using the same technique [16,17,24]. All guide pins in the robot group were basically successfully implanted at one time, while that in the conventional group needs to be adjusted twice or more.…”

“…In a study of 33 osteoporosis patients with sacral fractures, the authors compared robot-aided to conventional free-hand sacroiliac screw xation. They found that robotic assistance led to higher rates of screw placement accuracy, with the robot-aided group demonstrating an accuracy of 94.4% (vs 73.3%), using accuracy criterion previously set by Gras et al [17].…”

“…Additionally, since bony landmarks at the surgical site used in the process of guide pin implantation often need to be visualized clearly with uoroscopy, patients and surgeons are subject to large amounts of harmful radiation. Consequently, the desire for decreasing complication rates, avoiding excessive radiation and improving accuracy lead to the development of computer navigation and robotassisted surgery [16,17]. Although some studies on robot-assisted pelvic fracture xation have already been reported, minimally invasive triangular osteosynthesis with robotic assistance for the treatment of USFs is still lacking.…”

The Kocher-Langenbeck approach combined with robot-aided percutaneous anterior column screw fixation for transverse-oriented acetabular fractures: a retrospective study

“…Due to the uncertain entry point and the narrow bony corridor, it usually takes much time to insert the guiding wire accurately, with the consequence of excessive radiation exposure to patients and surgeons. Percutaneous fixation under the guidance of orthopedic robots has been reported with the advantages of accuracy and convenience [ 17 , 18 ]. Most important of all, robot-aided technology can also assist surgeons to plan, simulate and correct the trajectory of screws intraoperatively [ 17 , 18 ].…”

“…Percutaneous fixation under the guidance of orthopedic robots has been reported with the advantages of accuracy and convenience [ 17 , 18 ]. Most important of all, robot-aided technology can also assist surgeons to plan, simulate and correct the trajectory of screws intraoperatively [ 17 , 18 ]. So far, the percutaneous anterior column screw fixation is possibly to be an optimal choice for the patients suffering TOAFs, especially with transverse and transverse with posterior wall fractures.…”