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<p> This study evaluates therapeutic outcomes in thoracolumbar fractures with TLICS scores of 4, comparing robot-assisted surgery, minimally invasive percutaneous fixation, and conservative treatment.&#xa0;A retrospective analysis included 160 patients (robot-assisted: <i>n</i> = 68; conservative: <i>n</i> = 50; minimally invasive: <i>n</i> = 42). Outcomes assessed included bed rest duration, hospital stay, vertebral compression ratio (CR), Cobb angle, VAS pain scores, ODI functional scores, complications, and surgical parameters (screw accuracy, operative time, radiation exposure).&#xa0;Baseline characteristics were comparable across groups (<i>P</i> &gt; 0.05). At discharge, robot-assisted and minimally invasive groups demonstrated superior VAS reductions versus conservative treatment (<i>P</i> &lt; 0.05). At 3 months, both surgical groups maintained significantly lower VAS and ODI scores compared to the conservative group (<i>P</i> &lt; 0.05), although there was no significant difference between the two surgical approaches (<i>P</i> &gt; 0.05). No VAS/ODI disparities persisted beyond 6 months. Radiologically, surgical interventions (robot-assisted and minimally invasive) achieved better CR and Cobb angle stabilization versus conservative treatment at discharge and 24 months (<i>P</i> &lt; 0.05), with no inter-surgical differences. Complication rates were comparable (robot-assisted: 2.94%; conservative: 12%; minimally invasive: 4.76%; <i>P</i> = 0.13). Compared with minimally invasive techniques, robot-assisted surgery achieved significantly higher rates of optimal screw placement (Grade A/B) (<i>P</i> &lt; 0.05), significantly shorter operative time, and significantly reduced intraoperative radiation exposure (both <i>P</i> &lt; 0.05), despite higher costs.&#xa0;This study concludes that for TLICS-4 thoracolumbar fractures, surgical intervention provides better early pain reduction, functional improvement, and kyphosis prevention than conservative treatment. Robot-assisted surgery further enhances operative precision, efficiency, and radiation safety. Nonetheless, considering its substantial costs and study limitations, it should be viewed as one therapeutic alternative, with the final choice tailored to specific patient circumstances and clinical needs.</p><p><b>Level of Evidence Level III</b>: Retrospective comparative study.</p>

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Precision in the era of intelligent orthopedics: robot-assisted surgery enhances short-term recovery and long-term spinal stability for TLICS-4 thoracolumbar fractures

  • 期刊论文

  • 发表日期：

    2026年1月31日

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  • Ting Li,
  • Jin Li,
  • Yuanting Shang,
  • Xiaoyu Tang,
  • Xilin Liu,
  • Fei Wang

摘要

This study evaluates therapeutic outcomes in thoracolumbar fractures with TLICS scores of 4, comparing robot-assisted surgery, minimally invasive percutaneous fixation, and conservative treatment. A retrospective analysis included 160 patients (robot-assisted: n = 68; conservative: n = 50; minimally invasive: n = 42). Outcomes assessed included bed rest duration, hospital stay, vertebral compression ratio (CR), Cobb angle, VAS pain scores, ODI functional scores, complications, and surgical parameters (screw accuracy, operative time, radiation exposure). Baseline characteristics were comparable across groups (P > 0.05). At discharge, robot-assisted and minimally invasive groups demonstrated superior VAS reductions versus conservative treatment (P < 0.05). At 3 months, both surgical groups maintained significantly lower VAS and ODI scores compared to the conservative group (P < 0.05), although there was no significant difference between the two surgical approaches (P > 0.05). No VAS/ODI disparities persisted beyond 6 months. Radiologically, surgical interventions (robot-assisted and minimally invasive) achieved better CR and Cobb angle stabilization versus conservative treatment at discharge and 24 months (P < 0.05), with no inter-surgical differences. Complication rates were comparable (robot-assisted: 2.94%; conservative: 12%; minimally invasive: 4.76%; P = 0.13). Compared with minimally invasive techniques, robot-assisted surgery achieved significantly higher rates of optimal screw placement (Grade A/B) (P < 0.05), significantly shorter operative time, and significantly reduced intraoperative radiation exposure (both P < 0.05), despite higher costs. This study concludes that for TLICS-4 thoracolumbar fractures, surgical intervention provides better early pain reduction, functional improvement, and kyphosis prevention than conservative treatment. Robot-assisted surgery further enhances operative precision, efficiency, and radiation safety. Nonetheless, considering its substantial costs and study limitations, it should be viewed as one therapeutic alternative, with the final choice tailored to specific patient circumstances and clinical needs.

Level of Evidence Level III: Retrospective comparative study.