Biopsies vertébrales assistées par robot dans les spondylodiscites infectieuses

Vincent Goëb , Jean-Marc Sobhy Danial , Martial Ouendo , Johann Peltier , Michel Lefranc
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Abstract

The use of a vertebral biopsy remains very frequently relevant in the management of patients with infectious spondylodiscitis without identified germs or vertebral metastases without identified primary cancer in order to obtain bacteriological and/or histological proof of the disease. There are few Rheumatology departments which remain completely independent in carrying out these vertebral biopsies. We describe here a technique of spinal biopsies under robotic assistance. This aims to be more precise than current techniques, more comfortable for the patient, and to reduce the average length of stay of patients hospitalized in rheumatology. The biopsy is performed in the operating room by a rheumatologist/neurosurgeon duo guided by a robot. The precision of the biopsy is based on the acquisition of three-dimensional spinal anatomy by a plane sensor scanner coupled to the robot. This technique of vertebral biopsies is easily acquired and allows the rheumatologist to be independent from the first consultation to the aetiological diagnosis, then to the treatment of infectious spondylodiscitis. This technique is however dependent on the availability of an equipped operating theater.

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机器人辅助椎体活组织检查感染性椎体炎
为了获得疾病的细菌学和/或组织学证据,在未发现细菌的传染性脊柱炎或未发现原发性癌症的椎体转移患者的治疗中,椎体活检的使用仍然非常频繁。很少有风湿病科在进行这些椎体活组织检查时保持完全独立。我们在此描述一种在机器人辅助下的脊柱活检技术。其目的是比目前的技术更精确,对患者更舒适,并减少风湿病患者住院的平均时间。活组织检查由风湿病学家/神经外科医生二人组在机器人的指导下在手术室进行。活检的精度是基于三维脊柱解剖采集的平面传感器扫描仪连接到机器人。这种椎体活检技术很容易获得,并允许风湿病学家从第一次会诊到病因诊断,然后到传染性脊柱炎的治疗,都是独立的。然而,这种技术取决于是否有装备齐全的手术室。
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