精准医疗是未来医学发展的趋势，在脊柱外科领域，如何能在传统手术基础上进行改进，实现精准手术治疗，减少手术本身带来的损伤，是目前研究的热点。在治疗腰椎滑脱症和腰椎峡部裂方面，传统后正中切开的经椎间孔腰椎体间融合术（Open Transforaminal Lumbar Interbody Fusion, Open-TLIF）和峡部螺钉修补术（Open-Buck法）均需要沿腰椎后路进行肌肉韧带剥离，手术创伤大、术后并发症多。计算机辅助微创脊柱外科手术（Computer Assisted Minimally Invasive Spine Surgery, CAMISS）融合计算机辅助导航系统（Computer Assisted Navigation Surgery System, CANS）与脊柱微创手术（Minimally Invasive Spine Surgery, MISS），提高了手术精确性，减少了术中软组织损伤。将CAMISS技术应用于以上两种手术方式，可以实现手术的精准化和微创化。 本课题主要研究CAMISS技术的临床应用，采用注册登记的研究方式，评价CAMISS技术在治疗腰椎滑脱症和腰椎峡部裂的安全性和有效性。 通过预实验对入组最小样本量的估计，最终共有228例患者纳入CAMISS技术治疗腰椎滑脱症的注册登记研究，其中CAMISS-TLIF组109例，Open-TLIF组119例。结果显示，CAMISS-TLIF组患者在术中出血量、术后引流量、术后短期VAS评分及ODI评分等方面明显优于Open-TLIF组。在椎弓根螺钉置入精确性、椎间融合率、腰椎滑脱参数等方面，两组无统计学差异。CAMISS-TLIF组手术时间长于Open-TLIF组。 13例患者纳入CAMISS-Buck法治疗腰椎峡部裂的注册登记研究。结果显示，CAMISS-Buck法术后患者VAS评分及ODI评分均较术前有明显降低，峡部融合率与既往文献报道一致。结果表明，在治疗腰椎滑脱症方面，CAMISS-TLIF手术能达到与Open-TLIF手术相同的安全性，CAMISS技术的应用明显减少了术中损伤，减少了并发症及术后疼痛的发生，有利于患者术后恢复。在治疗腰椎峡部裂方面，CAMISS-Buck法能达到与传统手术相同的峡部融合率，且手术创伤更小。

Precision medicine is the highlight and future of medicine. In the field of spine surgery, how to improve surgical methods in order to achieve precise surgical treatment and reduce the potential damage is the focus of current research. In the field of lumbar spondylolisthesis and spondylolysis, both the traditional methods for treatment of lumbar spondylolisthesis (Open Transforaminal Lumbar Interbody Fusion, Open-TLIF) and the isthmus screw direct repair method (Open method) for treatment of spondylolysis need to peel along the posterior lumbar muscle ligaments, which inevitably leads to surgical damage and lots of complications. Computer Assisted Minimally Invasive Spine Surgery (CAMISS) is introduced to overcome the above shortages. CAMISS is the combination of Computer Assisted Navigation Surgery (CANS) and Minimally Invasive Spine Surgery (MISS), which can not only improve the surgical accuracy but also reduce the soft tissue injury. In a word, the CAMISS technology can achieve both the accuracy and the minimally invasive.This study is mainly focus on the clinical application of CAMISS technology. The main purpose of our research is to evaluate the safety and efficacy in treatment of lumbar spondylolisthesis and spondylolysis by CAMISS. We use the registration method to enroll and follow up patients.For the treatment of lumbar spondylilisthesis, we firstly finished a preliminary study in order to estimate the minimum number of patients enrolled. By calculation, 228 patients were enrolled in the registration study. The CAMISS-TLIF group has 109 cases while the Open-TLIF group enrolled 119 cases.For the treatment of lumbar spondylolysis, 13 cases were enrolled in the registration study of CAMISS in treating lumbar spondylolysis. We collected the clinical data, surgical information and follow-up materials.The results showed that patients in the CAMISS-TLIF group have less blood loss in surgery, less postoperative drainage, lower postoperative VAS and ODI scores than those in the Open-TLIF group. In terms of the accuracy of pedicle screw implantation, interbody fusion rate and other evaluation parameters, there was no significant difference between these two groups. Besides, the operative time in the CAMISS-TLIF group is longer than that in the Open-TLIF group.For the treatment of lumbar spondylolysis, CAMISS-Buck method had an advantage of lower postoperative VAS and ODI scores than the preoperative data. The isthmus fusion rate is consistent with the previous literature.In conclusion, the CAMISS-TLIF method can achieve the same safety compared with the Open-TLIF method. Besides, the CAMISS-TLIF technology can significantly reduce intraoperative injury as well as the incidence of complications and postoperative pain, which is helpful for postoperative recovery. In the treatment of lumbar spondylolysis, CAMISS-Buck method can achieve the same isthmus fusion rate compared with traditional surgery and cause less surgical damage.