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Objectives To compare the clinical outcomes of percutaneous robot‐assisted minimally invasive pedicle screw insertion versus freehand fluoroscopy‐assisted pedicle screw insertion using a traditional open technique in elderly patients undergoing an oblique lumbar interbody fusion (OLIF) procedure. Methods Based on the inclusion and exclusion criteria, 80 patients with lumbar degenerative disease who attended the spinal surgery department of the Beijing Jishuitan Hospital between January 2017 and April 2018 were enrolled in the present study. Patients were randomized 1:1 to undergo percutaneous robot‐assisted minimally invasive pedicle screw insertion (experimental group, n = 40) or freehand fluoroscopy‐assisted pedicle screw insertion using a traditional open technique (control group, n = 40). Outcomes were accuracy of screw placement evaluated on postoperative CT using the modified Gertzbein and Robbins scale, operative time, blood loss, postoperative drainage, lower back and leg pain evaluated using a visual analogue scale (VAS), lumbar function evaluated using the Oswestry disability index (ODI), and complication rates. Results A total of 344 vertebral pedicle screws were inserted: 170 screws in the experimental group, and 174 screws in the control group. Accurate screw placement was significantly higher in the experimental group (98.2% [167/170]) than in the control group (93.1% [162/174]). Clinical outcomes showed significant differences between the experimental and control groups in operative time, intraoperative blood loss, and postoperative VAS for lower back pain in the immediate postoperative period. Conclusion Robot‐assisted pedicle screw insertion in OLIF is an effective strategy for the management of elderly patients with lumbar degenerative diseases.

Postmenopausal osteoporosis (PMO) is the most common bone disorder in elderly Chinese women. Although genetic factors have been shown to have a pivotal role in PMO, studies on genetic loci associated with PMO in Chinese individuals are still lacking. We aimed to identify SNPs that contribute to PMO in Chinese individuals by conducting a genome-wide association study (GWAS). Bone mineral density (BMD) of postmenopausal Chinese women was assessed. Participants with T-score < −2.5 standard deviations (n = 341) were recruited and divided into a discovery group (n = 150) and a replication group (n = 191). GWAS was performed, with T-score as the quantitative trait, using linear regression. Our results revealed that an SNP cluster upstream of RREB1 showed a trend of association with BMD in Chinese PMO patients. The leading SNP of the cluster was rs475011 (pcombined = 1.15 × 10−6, beta = 0.51), which is a splicing quantitative trait locus (sQTL) of RREB1. This association was further supported by data from the UK Biobank (UKBB; p = 9.56 × 10−12). The high BMD-associated allele G of rs475011 is related to a high intron excision ratio. This SNP may increase BMD by upregulating mature RREB1 mRNA, based on data from the Genotype-Tissue Expression (GTEx) database. We identified BMD-associated SNPs that regulate RREB1 in Chinese PMO patients. Future functional experiments are needed to further link rs475011, RREB1, and PMO in Chinese individuals.

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