PDF(Pubmed)
Abstract：
UNASSIGNED: Radiofrequency thermal ablation (RFA) coupled with vertebroplasty or kyphoplasty offers a minimally invasive, safe, and efficacious approach to palliate polymetastatic spine disease, particularly in medically fragile individuals. However, the application of robotic assistance to RFA for spinal metastases remains unexplored. This study elucidates the technical viability of robot-assisted RFA combined with vertebroplasty in patients afflicted by multiple spinal metastases and presents preliminary outcomes. An illustrative case was also presented.
UNASSIGNED: Ten patients aged over 65 years with multiple vertebral metastases were enrolled in this study. Preoperatively, patients exhibited a median Visual Analog Scale (VAS) pain score of 6 and a Median Oswestry Disability Index (ODI) score of 58%. From February 2021 to April 2022, all patients underwent RFA, followed by vertebroplasty for spinal metastases. Surgical procedures were executed using the ExcelsiusGPS® robotic platform.
UNASSIGNED: Patients experienced substantial pain relief, with a median VAS score of 2.5 at 24 h postoperatively (Δ --3.5; P < 0.001) and a median VAS score of 2 at 1 month postoperatively (Δ -4; P < 0.001). All patients were discharged on the first postoperative day and continued their oncological treatments. In addition, the median ODI score at 1 month postoperatively was 34% (Δ --24%; P = 0.006), indicating an enhanced quality of life and a satisfactory impact on daily activities. No procedural or postoperative complications were documented.
UNASSIGNED: This case series represents the inaugural successful application of robot-assisted RFA in conjunction with concurrent vertebroplasty/kyphoplasty. Our preliminary experience demonstrates that patients with oligo- and polymetastatic conditions can derive benefits from this minimally invasive intervention, characterized by rapid postoperative recovery and effective short- to medium-term pain management, without encountering complications.
UNASSIGNED: Ten patients aged over 65 years with multiple vertebral metastases were enrolled in this study. Preoperatively, patients exhibited a median Visual Analog Scale (VAS) pain score of 6 and a Median Oswestry Disability Index (ODI) score of 58%. From February 2021 to April 2022, all patients underwent RFA, followed by vertebroplasty for spinal metastases. Surgical procedures were executed using the ExcelsiusGPS® robotic platform.
UNASSIGNED: Patients experienced substantial pain relief, with a median VAS score of 2.5 at 24 h postoperatively (Δ --3.5; P < 0.001) and a median VAS score of 2 at 1 month postoperatively (Δ -4; P < 0.001). All patients were discharged on the first postoperative day and continued their oncological treatments. In addition, the median ODI score at 1 month postoperatively was 34% (Δ --24%; P = 0.006), indicating an enhanced quality of life and a satisfactory impact on daily activities. No procedural or postoperative complications were documented.
UNASSIGNED: This case series represents the inaugural successful application of robot-assisted RFA in conjunction with concurrent vertebroplasty/kyphoplasty. Our preliminary experience demonstrates that patients with oligo- and polymetastatic conditions can derive benefits from this minimally invasive intervention, characterized by rapid postoperative recovery and effective short- to medium-term pain management, without encountering complications.
摘要：
■射频热消融（RFA）与椎体成形术或椎体后凸成形术相结合可提供微创，安全,有效治疗脊柱多转移性疾病，特别是在医学上脆弱的人。然而,机器人辅助在脊柱转移瘤RFA中的应用仍有待探索.这项研究阐明了机器人辅助RFA结合椎体成形术在患有多发性脊柱转移瘤的患者中的技术可行性，并提出了初步结果。还提出了一个说明性案例。
■本研究纳入了10例年龄超过65岁的多发性椎体转移患者。术前,患者的视觉模拟量表(VAS)疼痛评分中位数为6分,Oswestry残疾指数(ODI)评分中位数为58%.从2021年2月到2022年4月，所有患者都接受了RFA，其次是脊柱转移瘤的椎体成形术。使用ExcelsiusGPS®机器人平台执行外科手术。
■患者经历了实质性的疼痛缓解，术后24小时VAS评分中位数为2.5（Δ-3.5；P<0.001），术后1个月VAS评分中位数为2（Δ-4；P<0.001）。所有患者均在术后第一天出院，并继续进行肿瘤治疗。此外,术后1个月ODI评分中位数为34%(Δ-24%;P=0.006),表明生活质量提高，对日常活动产生令人满意的影响。无手术或术后并发症记录。
■该病例系列代表了机器人辅助RFA与同时进行的椎体成形术/椎体后凸成形术的首次成功应用。我们的初步经验表明，患有少和多转移性疾病的患者可以从这种微创干预中获益。其特点是术后快速恢复和有效的短期至中期疼痛管理，没有遇到并发症。
■本研究纳入了10例年龄超过65岁的多发性椎体转移患者。术前,患者的视觉模拟量表(VAS)疼痛评分中位数为6分,Oswestry残疾指数(ODI)评分中位数为58%.从2021年2月到2022年4月，所有患者都接受了RFA，其次是脊柱转移瘤的椎体成形术。使用ExcelsiusGPS®机器人平台执行外科手术。
■患者经历了实质性的疼痛缓解，术后24小时VAS评分中位数为2.5（Δ-3.5；P<0.001），术后1个月VAS评分中位数为2（Δ-4；P<0.001）。所有患者均在术后第一天出院，并继续进行肿瘤治疗。此外,术后1个月ODI评分中位数为34%(Δ-24%;P=0.006),表明生活质量提高，对日常活动产生令人满意的影响。无手术或术后并发症记录。
■该病例系列代表了机器人辅助RFA与同时进行的椎体成形术/椎体后凸成形术的首次成功应用。我们的初步经验表明，患有少和多转移性疾病的患者可以从这种微创干预中获益。其特点是术后快速恢复和有效的短期至中期疼痛管理，没有遇到并发症。
