Safety and clinical efficacy of modified tracer fixation technique in orthopedic robot-assisted percutaneous vertebroplasty for Kümmell's disease

Abstract

The rising incidence of osteoporotic vertebral compression fractures (OVCF) has increased the demand for precise treatments like robot-assisted percutaneous vertebroplasty (PVP), especially for conditions like Kümmell's disease that require high surgical accuracy. However, the traditional tracer fixation method has certain limitations. This study aimed to compare the safety and clinical efficacy of a modified tracer fixation technique with the traditional fixation method in robot-assisted percutaneous vertebroplasty (PVP) for Kümmell's disease. A retrospective analysis was conducted on 88 patients treated between April 2023 and January 2024. The patients were divided into two groups based on the tracer fixation method: the modified group (skin-fixed, 47 cases) and the traditional group (spinous process-fixed, 41 cases). Outcomes were measured by VAS, ODI, Cobb angle, working channel establishment time, surgical duration, intraoperative blood loss, intraoperative fluoroscopy dose, and complication rates. Both groups showed significant improvements in VAS, ODI, and Cobb angle at postoperative days 2 and 6 months (P < 0.05). The modified group had significantly lower VAS and ODI scores on postoperative days 2, shorter working channel establishment and surgical duration, and less intraoperative blood loss (P < 0.05). However, no significant differences were found in intraoperative fluoroscopy dose or complication rates (P > 0.05). In conclusion, while both techniques are safe and effective, the modified skin-fixed tracer technique offers advantages in reducing surgical trauma, significantly shortening the surgical duration, decreasing intraoperative blood loss, and promoting early recovery.

Keywords: Kümmell’s disease; Orthopedic robotics; Osteoporotic vertebral compression fractures; Percutaneous vertebroplasty; Tracer.