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Updated: Feb 1, 2026
05:57
A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
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Robotic versus freehand S2 alar iliac fixation: in-depth technical considerations
Joseph L Laratta1,2, Jamal N Shillingford1,2, Joshua S Meredith2
1Department of Orthopedic Surgery, Columbia University, New York, NY, USA.
Journal of Spine Surgery (Hong Kong)
|December 15, 2018
Summary
S2 alar-iliac (S2AI) screws offer improved pelvic fixation in spinal surgery. Robotic guidance enhances S2AI screw accuracy and safety, minimizing risks associated with this critical trajectory.
Area of Science:
- Spinal Surgery
- Orthopedic Instrumentation
- Robotic Surgery
Background:
- Lumbosacral junction fixation is challenging in spinal deformity correction.
- S2 alar-iliac (S2AI) trajectory offers pelvic fixation, reducing S1 screw strain.
- S2AI screws align with proximal instrumentation, potentially avoiding offset connectors.
Purpose of the Study:
- To evaluate the technical considerations and radiographic outcomes of S2AI screw insertion.
- To compare robotic-guided versus freehand insertion of S2AI screws.
- To assess the safety and accuracy of robotic guidance for S2AI screw placement.
Main Methods:
- Review of technical aspects and radiographic results for S2AI screw insertion.
- Comparison of robotic-assisted and freehand surgical techniques.
- Analysis of screw accuracy, with robotic guidance achieving over 95% accuracy.
Main Results:
- S2AI screws demonstrate effectiveness with low complication rates in current literature.
- Robotic guidance is safe and effective for achieving accurate S2AI screw trajectories.
- Technical considerations for both robotic and freehand S2AI screw insertion are discussed.
Conclusions:
- Robotic guidance provides a safe and highly accurate method for S2AI screw placement.
- S2AI screws are a viable option for pelvic fixation in spinal deformity surgery.
- Further understanding of technical nuances is crucial for optimal S2AI screw outcomes.
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