目的 探讨在经皮脊柱内镜髓核摘除术（percutaneous transforaminal endoscopic discectomy， PTED）中应用天玑骨科机器人改良导航系统的临床效果。方法 选取甘肃省中医院 2020 年 6 月至 2022 年 8 月，完成天玑机器人改良二维导航辅助下 PTED 手术操作 32 例（改良导航组），与同期在 C 臂引导下完 成 35 例 PTED 术（C 臂透视组），对两组 X 线透视次数、辐射剂量、工作通道置入时间、手术总时长、VAS 评 分、ODI 评分、技术学习曲线、手术并发症等进行统计分析。结果 改良导航组在X线透视次数、辐射剂量、 工作通道置入时间、手术总时长方面优于 C 臂透视组（P < 0.05）；两组患者手术前后 VAS 评分、ODI 评分比 较，差异均无统计学意义（P > 0.05），术后各时间点与术前组内比较差异均有统计学意义（P < 0.05）；两组 患者术中椎间孔成型情况、术后住院时间及患者术后并发症比较差异无统计学意义（P > 0.05）；改良导航 组学习曲线较 C 臂透视组低平，且手术时间恒定，随手术例数增加呈明显减少趋势（P < 0.05）；两组并发 症发生率比较差异无统计学意义（P < 0.05）；两组患者在术后末次随访时改良 MacNab 评分优良率比较， 差异无统计学意义（P > 0.05）。结论 天玑机器人改良导航系统在 PTED 术中应用，能减少手术时间，降 低术中辐射、手术风险，缩短PTED 技术的学习曲线。 

Objective To investigate the clinical effect of iRobot Ⅱ of orthopedic robotic system in per⁃ cutaneous endoscopic nucleus pulposectomy（PTED）. Methods From June 2020 to August 2022，32 patients （improved navigation group）who completed the modified two⁃dimensional navigation⁃assisted PTED by iRobot Ⅱ of orthopedic robotic system in our hospital and 35 patients（C⁃arm fluoroscopy group）who completed PTED under the guidance of C ⁃arm in the same period were selected. The number of X ⁃ ray fluoroscopy，radiation dose，insertion time of working channel，total operation time，VAS score，ODI score，technical learning curve，and surgical complications of the two groups were statistically analyzed. Results Less X⁃ray fluoroscopy times，lower radiation dose，reduced working channel insertion time and shorter total operation time were observed in improved navigation group（P < 0.05）. There was no significant difference in VAS score and ODI score between the two groups before and after operation（P > 0.05），but the comparison of VAS score and ODI score between the two groups at different time points after operation and intra⁃group comparison before operation showed statistical significance（P < 0.05）. There was no significant difference between the two groups in the formation of intervertebral foramen，the length of hospital stay and postoperative complications（P > 0.05）. The learning curve of the improved navigation group was lower and flater than that of the C⁃arm fluoroscopy group，and the operation time was constant，which was signifi⁃ cantly shortened with the increase of the number of operations（P < 0.05）. There was no significant difference in the incidence of complications between the two groups（P < 0.05）. There was no statistical difference in the excellent and good rate of the modified MacNab score between the two groups in the last follow⁃up（P > 0.05）. Conclusion There are shortened operation time，reduced radiation and operation risk during the operation and shortened learn⁃ing curve of PTED with the application of iRobot Ⅱ of orthopedic robotic system in PTED.