Author(s)

Tong Zhao^1*, Xianhai Zeng^2*, Feng Chen¹, Minghao Bi¹, Tao Jiang¹, Qianhou Zhou², Junlei Tan², Wenye Ma², Mingfu Li², Chengkua Huang^2#, Guosheng Su^3#

¹Department of Orthopedics, Peixian People’s Hospital, Xuzhou, China.
¹Department of Orthopedics, Peixian People’s Hospital, Xuzhou, China.
²Department of Spinal Surgery, Southwest Hospital Affiliated to Youjiang Medical University for Nationalities & Baise People’s Hospital, Baise, China.
²Department of Spinal Surgery, Southwest Hospital Affiliated to Youjiang Medical University for Nationalities & Baise People’s Hospital, Baise, China.
³Department of Laboratory Medicine, Guangxi-ASEAN Economic and Technological Development Zone People’s Hospital/Nanning Tenth People’s Hospital, Nanning, China.

Objective: To compare the application effects of Tianji orthopedic robot-assisted screw placement and traditional free-hand screw placement in posterior pedicle screw internal fixation for upper cervical fractures, and to provide a more optimal treatment plan for clinical practice. Methods: A retrospective analysis was conducted on 58 patients with upper cervical fracture who underwent surgery at Baise People’s Hospital from January 2017 to October 2023. The patients were divided into the robot-assisted group (RA group, 27 cases) and the traditional free-hand group (FH group, 31 cases). General data (gender, age, BMI, fracture site, etc.), screw placement accuracy (postoperative CT combined with Gertzbein-Robbins criteria), perioperative indicators (intraoperative blood loss, operation time, postoperative hospital stay), and prognosis (VAS score, NDI score, complications) were compared between the two groups. Results: There was no statistically significant difference in general data between the two groups (P > 0.05). In the RA group, among 112 screws, 109 were grade A + B (97.3%), with a perfect screw placement rate of 85.7%; in the FH group, among 137 screws, 123 were grade A + B (89.8%), with a perfect screw placement rate of 68.6%, and the difference in screw placement accuracy between the two groups was significant (P < 0.05). The intraoperative blood loss in the RA group was less than that in the FH group (245.93 ± 216.44 vs 380.65 ± 328.04, P < 0.05), the operation time was longer (P < 0.05), and the vertebral artery injury rate was lower (7.4% vs 22.6%). The postoperative VAS and NDI scores of both groups were improved compared with those before surgery (P < 0.05), and there were no statistically significant differences in postoperative hospital stay and total complications between the two groups (P > 0.05). Conclusion: Tianji orthopedic robot-assisted surgery has more advantages in improving screw placement accuracy, reducing blood loss, and lowering the risk of vertebral artery injury. It is safe, effective, and precise in operation, and is worthy of promotion.

Tianji Orthopedic Robot, Free-Hand Screw Placement, Upper Cervical Spine, Fracture, Pedicle Screw

Zhao, T. , Zeng, X. , Chen, F. , Bi, M. , Jiang, T. , Zhou, Q. , Tan, J. , Ma, W. , Li, M. , Huang, C. and Su, G. (2025) Application of Tianji Orthopedic Robot-Assisted Screw Placement versus Traditional Free-Hand Screw Placement in Upper Cervical Fractures. Advances in Bioscience and Biotechnology, 16, 422-436. doi: 10.4236/abb.2025.1610027.