Robot-assisted versus conventional fluoroscopy-guided percutaneous pediculoplasty for symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture without neurological deficits

To compare the efficacy of robot‑assisted (RA) and conventional fluoroscopy‑guided percutaneous vertebroplasty (PVP) combined with pediculoplasty in the treatment symptomatic chronic thoracolumbar osteoporotic vertebral fracture (SCOVF) without neurological deficits. This retrospective analysis included a total of 120 patients, with 87 in RA group and 33 in conventional group. Parameters such as operation time, volume of bone cement injected, and first-attempt success rate of puncture were recorded. Additionally, assessments were made for vertebral body index (VBI), bisegmental Cobb angle, visual analogue scale (VAS) score, Oswestry dysfunction index (ODI) score, and the occurrence of bone cement leakage or displacement during follow-up. The success rate of puncture was higher in RA group than conventional group (95.4% vs. 81.8%, P < 0.01). During follow-up, the values of VBI were 87.1 ± 4.5, 86.9 ± 4.3, 86.8 ± 4.3 in RA group which were higher than 83.6 ± 4.4, 84.1 ± 3.8, 84.4 ± 3.9 in conventional group (all P < 0.01). The VAS values in the RA group were 2.9 ± 1.0, 1.8 ± 0.7, 1.8 ± 0.7 points respectively, which were significantly lower than those in the conventional group 4.4 ± 1.1, 3.1 ± 0.8, 3.0 ± 0.9 points (all P < 0.01). There were no significant differences in bisegmental Cobb angle or ODI between two groups (P > 0.05). RA group exhibited a lower incidence of bone cement leakage and displacement [(8.0% vs. 30.3%, P < 0.01) and (0.0% vs. 9.1%, P < 0.05)]. Both surgical procedures are effective in treating SCOVF without neurological deficits. However, robot assistance offers several advantages, including enhanced puncture accuracy, satisfactory restoration of vertebral body height, rapid pain relief, reduced incidence of bone cement leakage, and effective prevention of cement displacement.