Learning Curve of Robot-Assisted Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures

There are few reports on the robot-assisted percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF), and we aimed to explore the learning curve of the robot-assisted PKP for treating OVCF.A total of 44 patients (71 vertebral fractures) with OVCF treated with robot-assisted PKP were divided into 4 groups, namely groups 1, 2, 3, and 4, according to the date of operation, with 11 cases in each group. Another 11 patients (18 vertebral fractures) treated with PKP without robot assistance were included in group 5. The success rate of robot-assisted puncture, total operation time, robot-assisted operation time, PKP operation time, and complications were analyzed.All patients underwent operation successfully. The success rates of puncture in the robot-assisted groups were 92.9%, 94.4%, 94.7%, and 100%, respectively, with no statistical difference (P > 0.05). The success rate of puncture in group 5 was 63.2%, with a statistical difference (P < 0.05) compared with groups 1-4. The total operation time and robotic operation time reduced significantly and remained relatively stable since the third group, and groups 1 and 2 showed a statistical significance compared with groups 3 and 4 (P < 0.05), but there was no difference among groups 3, 4, and 5 (P > 0.05). The main intraoperative complication was leakage of bone cement in the anterior vertebral space and intervertebral space, with an incidence of 8.5% in the robot-assisted groups and 26.3% in group 5.The puncture accuracy of robot-assisted PKP for treating OVCF does not change with the increase in the number of operations. The total operation time and robotic-assisted operation time decreases with the increase in the number of cases.