Robot-assisted versus fluoroscopy-assisted kyphoplasty in treatment of severe osteoporotic vertebral compression fractures in the old patients: a retrospective study

Abstract Background Although percutaneous kyphoplasty (PKP) is used to treat severe osteoporotic vertebral compression fractures (OVCF), the unsatisfactory effect of bone cement reduction and leakage is a concern. In recent years, the application of surgical robots in the field of orthopaedics has s...

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Main Authors: Peng Liu, Jiang Hu, Wei Zhang, Fei Wang, Liuyi Tang, Weijun Zhou, Shu Lin
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08564-5
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author Peng Liu
Jiang Hu
Wei Zhang
Fei Wang
Liuyi Tang
Weijun Zhou
Shu Lin
author_facet Peng Liu
Jiang Hu
Wei Zhang
Fei Wang
Liuyi Tang
Weijun Zhou
Shu Lin
author_sort Peng Liu
collection DOAJ
description Abstract Background Although percutaneous kyphoplasty (PKP) is used to treat severe osteoporotic vertebral compression fractures (OVCF), the unsatisfactory effect of bone cement reduction and leakage is a concern. In recent years, the application of surgical robots in the field of orthopaedics has shown promising prospects. Since 2017, our hospital has used surgical robot-assisted PKP to treat severe OVCF. Methods One hundred and fifty-five old patients with severe OVCF who had undergone PKP were retrospectively analyzed and stratified into two groups: robot-assisted (n = 88) and fluoroscopy-assisted (n = 67). The surgical time, intraoperative radiation dose, surgical efficacy (analgesic effect and limb function), imaging evaluation (accuracy of puncture, distribution of bone cement, reduction of vertebral height, and rectification of Cobb angle), and leakage of bone cement were analyzed to evaluate the potential advantages of robot-assisted PKP in the treatment of severe OVCF. Results There were significant differences in surgical time (P < 0.001), intraoperative radiation dose (P < 0.001), analgesic effect (P = 0.001), accuracy of puncture (P = 0.008), distribution (P = 0.013), and leakage of bone cement (P = 0.019) between the two groups. However, postoperative limb function (P = 0.612), reduction in vertebral height (P = 0.068), and rectification of the Cobb angle (P = 0.243) were similar in both groups. Conclusions The application of robot-assisted PKP for treating severe OVCF (Genant Grade III) can slightly shorten surgery time and significantly reduce intraoperative total radiation exposure for both patients and clinicians. Additionally, it improves puncture accuracy and reduces the cement leakage rate, ultimately achieving satisfactory pain relief. However, in terms of functional recovery, no significant differences were observed between the two approaches.
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spelling doaj-art-c8f4940f5bd14af79bf1208e1292e0862025-08-20T01:52:59ZengBMCBMC Musculoskeletal Disorders1471-24742025-04-012611910.1186/s12891-025-08564-5Robot-assisted versus fluoroscopy-assisted kyphoplasty in treatment of severe osteoporotic vertebral compression fractures in the old patients: a retrospective studyPeng Liu0Jiang Hu1Wei Zhang2Fei Wang3Liuyi Tang4Weijun Zhou5Shu Lin6Department of Orthopedic Surgery, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaDepartment of Orthopedic Surgery, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaDepartment of Orthopedic Surgery, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaDepartment of Orthopedic Surgery, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaDepartment of Orthopedic Surgery, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaDepartment of Orthopedic Surgery, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaDepartment of Orthopedic Surgery, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaAbstract Background Although percutaneous kyphoplasty (PKP) is used to treat severe osteoporotic vertebral compression fractures (OVCF), the unsatisfactory effect of bone cement reduction and leakage is a concern. In recent years, the application of surgical robots in the field of orthopaedics has shown promising prospects. Since 2017, our hospital has used surgical robot-assisted PKP to treat severe OVCF. Methods One hundred and fifty-five old patients with severe OVCF who had undergone PKP were retrospectively analyzed and stratified into two groups: robot-assisted (n = 88) and fluoroscopy-assisted (n = 67). The surgical time, intraoperative radiation dose, surgical efficacy (analgesic effect and limb function), imaging evaluation (accuracy of puncture, distribution of bone cement, reduction of vertebral height, and rectification of Cobb angle), and leakage of bone cement were analyzed to evaluate the potential advantages of robot-assisted PKP in the treatment of severe OVCF. Results There were significant differences in surgical time (P < 0.001), intraoperative radiation dose (P < 0.001), analgesic effect (P = 0.001), accuracy of puncture (P = 0.008), distribution (P = 0.013), and leakage of bone cement (P = 0.019) between the two groups. However, postoperative limb function (P = 0.612), reduction in vertebral height (P = 0.068), and rectification of the Cobb angle (P = 0.243) were similar in both groups. Conclusions The application of robot-assisted PKP for treating severe OVCF (Genant Grade III) can slightly shorten surgery time and significantly reduce intraoperative total radiation exposure for both patients and clinicians. Additionally, it improves puncture accuracy and reduces the cement leakage rate, ultimately achieving satisfactory pain relief. However, in terms of functional recovery, no significant differences were observed between the two approaches.https://doi.org/10.1186/s12891-025-08564-5Osteoporosis vertebral compression fracturesPercutaneous kyphoplastyBone cement leakageRobot-assisted
spellingShingle Peng Liu
Jiang Hu
Wei Zhang
Fei Wang
Liuyi Tang
Weijun Zhou
Shu Lin
Robot-assisted versus fluoroscopy-assisted kyphoplasty in treatment of severe osteoporotic vertebral compression fractures in the old patients: a retrospective study
BMC Musculoskeletal Disorders
Osteoporosis vertebral compression fractures
Percutaneous kyphoplasty
Bone cement leakage
Robot-assisted
title Robot-assisted versus fluoroscopy-assisted kyphoplasty in treatment of severe osteoporotic vertebral compression fractures in the old patients: a retrospective study
title_full Robot-assisted versus fluoroscopy-assisted kyphoplasty in treatment of severe osteoporotic vertebral compression fractures in the old patients: a retrospective study
title_fullStr Robot-assisted versus fluoroscopy-assisted kyphoplasty in treatment of severe osteoporotic vertebral compression fractures in the old patients: a retrospective study
title_full_unstemmed Robot-assisted versus fluoroscopy-assisted kyphoplasty in treatment of severe osteoporotic vertebral compression fractures in the old patients: a retrospective study
title_short Robot-assisted versus fluoroscopy-assisted kyphoplasty in treatment of severe osteoporotic vertebral compression fractures in the old patients: a retrospective study
title_sort robot assisted versus fluoroscopy assisted kyphoplasty in treatment of severe osteoporotic vertebral compression fractures in the old patients a retrospective study
topic Osteoporosis vertebral compression fractures
Percutaneous kyphoplasty
Bone cement leakage
Robot-assisted
url https://doi.org/10.1186/s12891-025-08564-5
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