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Updated: Aug 28, 2025

A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Pearls and pitfalls of posterior superior iliac spine reference frame placement for spinal navigation: cadaveric
Brendan F Judy1, Hector Soriano-Baron1, Yike Jin1
11Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland; and.
Background:
Navigation and robotics are important tools in the spine surgeon's armamentarium and use of these tools requires placement of a reference frame. The posterior superior iliac spine (PSIS) is a commonly used site for reference frame placement, due to its location away from the surgical corridor and its ability to provide solid fixation. Placement of a reference frame requires not only familiarity with proper technique, but also command of the relevant anatomy.
Observations:
Cadaveric analysis demonstrates a significant difference in PSIS location in males versus females, and additionally provides average thickness for accurate placement.
Lessons:
In this technical note, the authors describe the precise technique for PSIS frame placement in addition to relevant anatomy and offer solutions to commonly encountered problems.

