Robot-assisted atlantoaxial fixation: illustrative cases

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Robotics in Medicine

Background:

• High cervical spine surgery presents anatomical challenges due to vital structures.
• Precise screw placement is critical for patient safety and surgical outcomes.
• Robotic assistance is emerging as a tool to enhance precision in spinal instrumentation.

Observation:

• Two cases utilized a novel robotic setup for C2 pars and C1-2 transarticular screw placement.
• Surgical plans included C2 pars screws for hangman's fracture and C1-2 transarticular screws for degenerative disease.
• Intraoperative computed tomography (CT) guided screw navigation and placement.

Findings:

• Postoperative CT confirmed excellent hardware placement in both cases.
• Patients experienced no recurrence of preoperative symptoms at initial follow-up.
• The robotic system facilitated accurate placement of C2 pars and C1-2 transarticular screws.

Implications:

• Intraoperative robotic assistance may improve the accuracy of high cervical spine instrumentation.
• This technology has the potential to minimize risks associated with C2 pars and C1-2 transarticular screw placement.
• Robotic systems offer a promising approach for complex cervical spine procedures.