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Updated: Jul 19, 2026
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A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
Computer-assisted screw insertion for cervical disorders in rheumatoid arthritis
Jun Takahashi1, Yasuhiro Shono, Isao Nakamura
1Department of Orthopaedic Surgery, Shinshu University, School of Medicine, Matsumotoshi Asahi 3-1-1, Nagano, 390-8621, Japan. jtaka@hsp.md.shinshu-u.ac.jp
Summary
Image-guided systems enable safe and accurate cervical pedicle screw fixation in rheumatoid arthritis patients. This technique minimizes neurovascular risks in complex spinal deformities, improving surgical outcomes.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Medical Imaging
Background:
- Rheumatoid arthritis (RA) causes severe cervical spine instability and deformities.
- Traditional C1/2 transarticular and pedicle screw fixation in RA patients are technically challenging due to anatomical variations and carry risks of neurovascular injury.
Observation:
- A frameless, stereotactic, CT-based, optoelectronic image-guidance system was utilized for screw placement in 21 RA patients.
- Postoperative CT and X-ray evaluated screw accuracy, while neural and vascular complications were monitored.
Findings:
- Image-guidance systems demonstrated high accuracy for cervical pedicle screw insertion in RA patients.
- Only 1 out of 48 screws showed a critical breach (>25%) of the vertebral artery canal, with no observed neurovascular complications.
- No instrumentation failure, loss of reduction, or nonunion occurred during the average 49.5-month follow-up.
Implications:
- Image-guidance systems are safe and effective for complex cervical spine surgeries in RA patients.
- This technology aids in preoperative planning and precise screw placement, reducing surgical risks.
- The findings support the routine use of image-guidance systems for RA cervical spine reconstruction.
