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Updated: Oct 11, 2025
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A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
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Robotic-guidance allows for accurate S2AI screw placement without complications
Christopher R Good1, Lindsay D Orosz2, Alexandra E Thomson3
1Virginia Spine Institute, 11800 Sunrise Valley Drive, Reston, VA, 20191, USA. chrisgoodspine@gmail.com.
Journal of Robotic Surgery
|December 2, 2021
Summary
Robotic-guided S2 alar-iliac (S2AI) screw placement for posterior spine fusion demonstrated excellent safety and accuracy. This technique offers reliable pelvic fixation with zero complications or revisions in the study cohort.
Area of Science:
- Spine Surgery
- Robotic Surgery
- Orthopedic Implants
Background:
- Pelvic fixation is crucial in posterior spinal fusion.
- Traditional S2AI screw placement can be challenging.
- Robotic guidance offers potential for improved accuracy and safety.
Purpose of the Study:
- To evaluate complication rates, revision rates, and accuracy of robotic-guided S2 alar-iliac (S2AI) screws.
- To assess the reliability of robotic systems for pelvic fixation in spine surgery.
Main Methods:
- Retrospective, single-center review of 65 patients undergoing S2AI fixation (118 screws) using robotic guidance (Mazor X/XSE).
- Screws placed percutaneously or in open fashion by three surgeons.
- Postoperative CT scans reviewed for accuracy grading (n=46 screws).
Main Results:
- No intraoperative or postoperative complications related to S2AI screw placement.
- Zero revisions required due to S2AI screw issues.
- All 46 evaluated screws achieved Grade A accuracy (0 mm breach).
Conclusions:
- Robotic-guided S2AI screw placement is a reliable technique for pelvic fixation.
- This method achieves high accuracy with low complication and revision rates.
- It avoids reliance on anatomical landmarks and reduces radiation exposure compared to freehand or fluoroscopic techniques.
