Abstract: BACKGROUND: Multi-modal medical image fusion technology is currently mostly used for clinical diagnosis, pathological change tracking and treatment, and radiotherapy, but the combined intelligent robotic arm assisted vertebral body augmentation is rarely used in clinical application.  
OBJECTIVE: To evaluate the safety and effectiveness of multi-modal image fusion combined with intelligent robotic arm assisted in establishing vertebral augmentation channels.
METHODS:  Sixty-two patients with osteoporotic vertebral compression fracture vertebral augmentation were included in this study and randomly divided into two groups. The 31 cases in the trial group underwent multi-modal image fusion by mechanical arm to build the vertebral strengthening channel. The 31 cases in the control group underwent conventional method to establish the vertebral strengthening channel. Vertebral augmentation was performed with the same bone cement injection under the same rules. The number of intraoperative index, postoperative pain score, and number of re-fractures of injured vertebrae were recorded. Statistical analysis was conducted to evaluate the results.  
RESULTS AND CONCLUSION: (1) The puncture time, fluoroscopy times, total dose of radiation exposure, puncture adjustment times, bone cement leakage, positioning time, and visual analogue scale score of pain 1 day after operation in the trial group were significantly lower than those in the control group (P < 0.001). The excellent and good rates of puncture accuracy, bone cement injection volume, and bone cement dispersion were significantly higher in the trial group than those in the control group (P < 0.001). The number of positioning fluoroscopy was not significantly different between the two groups. (2) No infection occurred in patients of the two groups. In the control group, one patient was found with cement emboli in the double pulmonary arteries; one patient had no long-term relief of postoperative pain; and three patients were diagnosed with re-fracture of injured vertebra due to pain reissue MRI examination within 6 months. No such complications were seen in the trial group during follow-up. (3) It is concluded that the establishment of vertebral enhancement channel assisted by multi-modal image fusion and intelligent robotic arm can improve the accuracy of pedicle localization and puncture and the effect of vertebral augmentation, and effectively reduce the number of fluoroscopy, radiation exposure dose and the occurrence of complications; it is safe and reliable.

Key words: multimodal image fusion, intelligent manipulator, vertebral augmentation, channel, osteoporosis, vertebral fractures, bone cement, radiation exposure dose