| OBJECTIVE:1.To evaluate the safety and efficacy of image-guided percutaneous microwave ablation in the treatment of spinal metastases.2.To explore the influence of insertion experience on the effects in exploring the model of VX2 vertebral body in New Zealand white rabbits.and to compare the puncture guided by CT-guided puncture robot and guided puncture robot.3.To compare the study of optical guided puncture robot assisted puncture ablation and conventional CT-guided puncture ablation in New Zealand white rabbit model of VX2 vertebral tumor.Materials and Methods:1.All cases of spinal metastases from December 2016 to December 2019 were reviewed,the suitable cases for percutaneous microwave ablation were selected,The VAS scores and perioperative complications were recorded before and after surgery.2.To explore the model of VX2 vertebral body in New Zealand white rabbits,the procedure was established by doctors With or without Puncture experience through CT-guided and optically guided puncture robot systems respectively.3.The model of VX2 vertebral body tumor in New Zealand white rabbits were established.To compare the differences between optical guided puncture robot assisted puncture ablation and conventional CT-guided puncture ablation.The puncture times,puncture time,puncture success rate and image data before and after surgery were recorded.Results:1.Twenty-three patients with spinal metastases were included in this study.The mean preoperative VAS score was 8.17±1.46 points(range from 6-10 points),The average VAS score 24 hours after surgery was 2.17±1.19 points.The VAS scores decreased significantly before and after surgery,and the comparison between the two groups was statistically significant(P<0.05),VAS scores of different primary cancer sources were compared before and after surgery,the comparison between the two groups was statistically significant(P<0.05),VAS scores of two different properties of lesions were compared before and after surgery,the comparison between the two groups was statistically significant(P<0.05).2.There were statistically significant differences between the data of traditional group and the robot group when the insertion procedure was perfomed(P<0.05).There was no statistically significant difference between the data of experience group and that of no experience group when the insertion procedure was perfomed the doctors with and without experience by CT guidance(P>0.05).There was no statistically significant difference between the data of experience group and that of no experience group when the insertion procedure was perfomed with robot-assisted navigation(P>0.05).3.By comparing the optical guided puncture robot assisted ablation group to the CT-guided puncture ablation group,The former had fewer puncture times and fewer puncture times on average.There were statistically significant difference between the data of traditional group and that of the robot group(P<0.05).Tumor volume was significantly reduced on magnetic resonance imaging 1 week before and after ablation.There were statistically significant difference between the data of traditional group and that of the robot group(P<0.05).However,the difference between the two groups was not statistically significant(P>0.05).CONCLUSIONS:1.Percutaneous microwave ablation of spinal metastases is a safe and effective way to relieve cancerous pain.2.There was no influence of experience on insertion precision,time and comfortability on insertion procedure with robot-assisted navigation and CT-guided group.When performed by the doctors,the insertion procedure with robot-assisted nabigating system was higher insertion precision,shorter insertion time and more insertion comfortability compared weith those of traditiaonal group.3.Compared with traditional CT guided microwave ablation,robot-assisted navigation guided microwave ablation has obvious advantages in one-time puncture time and comfortances in the model of VX2 vertebral body tumor in New Zealand white rabbits.However,they have the same ablation efficiency. |
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