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Research on Key Technology Development and Clinical Application of Small Interactive Spinal Endoscopic Surgery Robot

Recruiting
Conditions
Lumbar Disc Herniation
Lumbar Spinal Stenosis
Registration Number
NCT06480214
Lead Sponsor
Beijing Jishuitan Hospital
Brief Summary

The aim of the study was to investigate the correlation between the extent of decompression and patient follow-up metrics at 1 year postoperatively by analysing data from a real-world, multicentre cohort of patients, and to clarify the precise extent of decompression for endoscopic spine surgery.

Detailed Description

In recent years, endoscopic spine surgery has developed rapidly, especially in the treatment of degenerative spinal diseases. Minimally invasive endoscopic spine surgery has been widely implemented and promoted in hospitals at all levels. The learning curve of endoscopic spinal surgery is steep because it is performed in a narrow space adjacent to sensitive structures such as nerves and blood vessels. The surgical effect completely depends on the experience of the surgeon. How to break through the bottleneck and forbidden zone of endoscopic spine surgery and establish a perfect treatment system for endoscopic spine surgery has become one of the urgent problems and challenges in current spine surgery. At present, enabling technologies such as artificial intelligence, computer-assisted surgical navigation and robotics have been applied in spinal surgery, but their functions are limited to stereotactic orientation. Endoscopic spinal surgery robots that can meet the needs of intelligent surgical planning, precise decompression and flexible micromanipulation under endoscope are still lacking in the world. It is of great practical significance to develop an endoscopic spinal surgery robot platform with artificial intelligence characteristics, and based on this, establish an endoscopic spinal surgery treatment system oriented by accurate, safe and effective improvement of patient clinical outcomes, which is expected to improve the level of diagnosis and treatment of spinal surgery and promote the transformation and industrialization of a new generation of surgical technology. The objectives of this project include: 1) to conduct a real-world study on the precise decompression range of endoscopic spine surgery, to investigate the artificial intelligence-assisted spinal segmentation and automatic decompression planning for endoscopic spine surgery; 2) Develop a new generation of small interactive intelligent endoscopic robot system and supporting new minimally invasive surgical instruments, and study the human-computer interaction control strategy suitable for narrow space; 3) Carry out the effectiveness and safety research of the endoscopic spinal surgery robot, and verify it in model bones, animal bones and humans in general. The products are approved and clinical trials are completed after the relevant parts are filed. Finally, a small interactive endoscopic surgery robot platform and an intelligent decompression planning system were successfully developed, which clarified the scope and operation specification of accurate endoscopic decompression, provided guidance for the popularization of endoscopic surgery, and formed the operation process specification of small interactive minimally invasive endoscopic surgery.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1000
Inclusion Criteria
  1. Patients with lumbar spinal stenosis or lumbar disc herniation with narrow central canal and lateral recess of single lumbar vertebra;
  2. formal conservative treatment is ineffective for at least 3 months;
  3. Voluntary surgery and follow-up for more than 6 months;
  4. Sign informed consent.
  5. The patient is > 18 years old and has the ability to act autonomously.
Exclusion Criteria
  1. Previous history of lumbar surgery; 2, combined with lumbar spondylolisthesis, lumbar instability or spinal deformity; 3, there are surgical contraindications, can not perform surgery; 4, can not follow up on time after surgery or lost visitors.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Postoperative 1-year incidence of complications1 year after surgery

the incidence of complications such as neural injury, postoperative bleeding, dural tear, wound infection etc, 1 year after the operation

Secondary Outcome Measures
NameTimeMethod
Post-operative reoperation rate1 year

the reoperation rate in the 1-year postoperation period

Postoperative lumbar spine function score1 year

We would measure the lumbar spine function score, such as SSM (Spinal Stenosis Measure), JOA (Japanese Orthopaedic Association), ODI (Oswestry Disability Index) and VAS (Visual Analog Scale), after surgery. Higher scores of SSM, JOA, ODI and VAS means worse outcome.

Weishupt score for degeneration of the small joints of the lumbar spine1 year

Weishupt score was used to evaluate the degree of degeneration of the small joints of the lumbar spine. Higher scores of Weishupt score means higher levels of spine degeneration

Degree of fatty infiltration of lumbar spine muscles1 year

Degree of fatty infiltration is measured by MRI scanning

Range of bony decompression of the lumbar spinal canal1 year

The range of decompression of the bone structures during the surgery

White-Panjabi score for lumbar spine stability1 year

White-Panjabi score was used to evaluate the lumbar spine stability. Higher scores of Panjabi score means higher levels of spine instability

Post-operative recurrence rate1 year

The recurrence rate after surgery

Record of postoperative rehabilitation exercises1 year

rehabilitation exercises patients made after surgery

Surgical level lumbar spinal canal area1 year

The level of lumbar spinal canal in the surgery

Lumbar spine mobility and isometric muscle strength1 year

The measurement of muscle mobidity and strength

Trial Locations

Locations (1)

Beijing Jishuitan Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

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