{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T19:16:03Z","timestamp":1793819763459,"version":"4.6.1"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Studies have compared the safety and accuracy of robot\u2010assisted techniques for inserting conventional open pedicle screws for spinal surgery. However, no relevant studies have confirmed that robot\u2010assisted percutaneous screw placement is better than fluoroscopic percutaneous screw placement for the treatment of thoracolumbar fractures. This study compared the accuracy and safety of TiRobot\u2010assisted percutaneous pedicle screw placement with those of the fluoroscopy\u2010assisted percutaneous technique for the treatment of thoracolumbar fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 126 patients with thoracolumbar fractures who underwent percutaneous pedicle screw placement. Sixty\u2010five patients were treated with the TiRobot\u2010assisted technique and 61 patients were treated with the fluoroscopy\u2010assisted technique. Patient demographics, accuracy of screw placement (according to the Gertzbein and Robbins scale of grades A to E), screw insertion angle, radiation exposure, surgical time, intraoperative blood loss, length of hospital stay, incision length, hospital expenses, surgical site infection, and neurological injury of the TiRobot\u2010assisted and fluoroscopy\u2010assisted groups were compared using Student's t\u2010test, Pearson \u03c7<jats:sup>2<\/jats:sup> test, or Fisher's exact test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 729 screws were placed (TiRobot\u2010assisted group: 374 screws; fluoroscopy\u2010assisted group: 355 screws). In the TiRobot\u2010assisted group, 82.8% of screws were optimally positioned (grade A); however, the placement grades of the remaining screws were categorized as grade B (13.3%), grade C (3.2%), and grade D (0.5%). In the fluoroscopy\u2010assisted group, 66.7% of the screws were optimally positioned (grade A); however, the placement grades of the remaining screws were categorized as grade B (21.4%), grade C (7.6%), grade D (3.6%), and grade E (0.5%). The proportion of clinically acceptable screws (grade A or B) was greater in the TiRobot\u2010assisted group than in the fluoroscopy\u2010assisted group. Additionally, the TiRobot\u2010assisted group had a significantly larger mean screw insertion angle (22.27\u00b0\u2009\u00b1\u20095.48\u00b0 <jats:italic>vs<\/jats:italic> 20.55\u00b0\u2009\u00b1\u20095.15\u00b0), larger incision length (13.86\u2009\u00b1\u20091.24\u2009cm <jats:italic>vs<\/jats:italic> 12.77\u2009\u00b1\u20091.43\u2009cm), and higher hospital expenses (69061.55\u2009\u00b1\u20097166.60\u2009yuan <jats:italic>vs<\/jats:italic> 59383.85\u2009\u00b1\u20095019.64\u2009yuan) than the fluoroscopy\u2010assisted group. There were no significant differences in the intraoperative blood loss, length of hospital stay, and rates of surgical site infection and neurological injury in both groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). However, the TiRobot\u2010assisted group had significantly better surgical times, radiation times, and radiation exposure than the fluoroscopy\u2010assisted group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Percutaneous TiRobot\u2010assisted pedicle screw placement is a safe, useful, and potentially more accurate alternative to the percutaneous fluoroscopy\u2010assisted technique for treating thoracolumbar fractures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13504","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T09:16:39Z","timestamp":1664529399000},"page":"2955-2963","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Comparison of the Accuracy and Safety of <scp>TiRobot<\/scp>\u2010Assisted and Fluoroscopy\u2010Assisted Percutaneous Pedicle Screw Placement for the Treatment of Thoracolumbar Fractures"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8185-9754","authenticated-orcid":false,"given":"Shu","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu\u2010yi","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China  Chengdu 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