Robotic assisted fixation of sacral fractures: A pilot study

Area of Science:

• Orthopedic Surgery
• Robotics in Medicine
• Trauma Care

Background:

• Sacral fractures present significant surgical challenges due to complex anatomy.
• Implant insertion for sacral fixation requires specialized skills and carries inherent risks.
• Robotic systems have proven effective for spinal procedures like pedicle screw insertion.

Purpose of the Study:

• To demonstrate the feasibility and efficacy of robotic-assisted fixation for unstable sacral fractures.
• To evaluate the accuracy and safety of robotic guidance in sacral fracture treatment.
• To explore the application of robotic technology in complex orthopedic trauma.

Main Methods:

• Retrospective case series involving 14 patients with various sacral fractures (high-energy, osteoporotic, pathological).
• Robotic system (Renaissance) used for planning and guiding percutaneous insertion of fixation hardware (iliosacral screws, etc.).
• Implant trajectories planned using pre- or intraoperative 3D imaging.

Main Results:

• All 14 sacral fractures achieved successful healing with no hardware failure.
• Accurate implant placement within bony confines was confirmed, with no neurological deficits.
• Mean operative time was 150 minutes, with average fluoroscopy times of 18s (2D) and 40s (3D).

Conclusions:

• Robotic-assisted fixation is a safe and reproducible technique for sacral fractures.
• The system allows for precise and accurate placement of orthopedic implants in the sacrum.
• This technology enhances treatment options for complex sacral fracture fixation.