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Updated: Jul 14, 2026
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A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
Image-guided transarticular atlanto-axial screw fixation
M O Kelleher1, L McEvoy, J Nagaria
1National Neurosurgical Unit, Dublin, Ireland.
Summary
Frameless stereotaxy enables safe C1/C2 transarticular screw insertion for atlanto-axial instability. This image-guided technique minimizes risks like neural or vascular injury, ensuring optimal screw placement.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Atlanto-axial instability presents surgical challenges.
- C1/C2 transarticular screw fixation is a common treatment.
- Safe screw insertion requires precise technique.
Purpose of the Study:
- To evaluate the safety and efficacy of frameless stereotaxy for C1/C2 transarticular screw fixation.
- To assess the role of image guidance in minimizing complications.
- To outline the clinical application of this technique.
Main Methods:
- Retrospective review of patients undergoing image-guided C1/C2 transarticular screw fixation.
- Evaluation of 60 patients with 109 screws inserted.
- Outcomes assessed included neural injury, vascular injury, death, and screw placement.
Main Results:
- No intraoperative complications were reported in the evaluated cases.
- Image guidance facilitated accurate screw placement.
- The technique demonstrated a high safety profile.
Conclusions:
- Frameless stereotaxy is a safe and effective method for C1/C2 transarticular screw fixation.
- Image guidance aids in preoperative planning and trajectory optimization.
- This approach helps avoid critical structures like the vertebral artery.
