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Updated: Jul 16, 2025
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A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
8.9K
100 Complex posterior spinal fusion cases performed with robotic instrumentation
Brian McCormick1, Paul L Asdourian2, Douglass C Johnson3
1MedStar Union Memorial Hospital, Baltimore, MD, USA. brian.p.mccormick1@gmail.com.
Journal of Robotic Surgery
|September 14, 2023
Summary
Robotic-assisted spinal fusion surgery in 100 multilevel cases showed low hardware failure rates (1.7% for pedicle screws, 5.7% for S2AI screws) and no malpositioning. This technique offers precision and safety for complex spinal procedures.
Area of Science:
- Spinal surgery
- Robotics in medicine
- Orthopedic surgery
Background:
- Robotic navigation enhances precision, accuracy, and safety in spinal reconstructive surgery.
- Limited literature exists on robotic techniques for complex, multilevel spinal cases or significant deformity correction.
Observation:
- A case series of 100 consecutive multilevel posterior spinal fusions was conducted for multilevel disease and/or deformity correction.
- Robotic-assisted pedicle screw placement was utilized in all cases, including 28 with S2 alar-iliac (S2AI) screws.
- The study included 31 revision surgeries with existing hardware.
Findings:
- A total of 1043 pedicle screws and 53 S2AI screws were robotically placed.
- The overall failure rate for pedicle screws was 1.7% (18/1043), and for S2AI screws was 5.7% (3/53).
- No screws required reoperation due to malpositioning, and postoperative infection rates were comparable to historical controls.
Implications:
- Robotic-assisted screw placement in multilevel posterior spinal fusions demonstrates promising low failure rates and high accuracy.
- This technique is suitable for complex spinal pathologies and deformity correction, ensuring precise screw placement.
- Robotic navigation can be safely integrated into complex spinal fusion procedures without increasing infection risk.
