Percutaneous sacroiliac screw fixation with a 3D robot-assisted image-guided navigation system : Technical solutions

Area of Science:

• Orthopedic Surgery
• Robotics in Medicine
• Trauma Management

Background:

• Pelvic fractures, especially fragility fractures, pose significant challenges in posterior fixation.
• Percutaneous techniques aim to minimize invasiveness but require precise screw placement.

Purpose of the Study:

• To describe and evaluate the clinical outcomes of percutaneous sacroiliac screw fixation using a 3D robot-assisted image-guided navigation system.
• To assess the safety and efficacy of this advanced technique for posterior pelvic fractures.

Main Methods:

• Retrospective analysis of 141 patients undergoing 3D robot-assisted SI screw fixation for pelvic fractures.
• Surgical technique involves CT-based planning, intraoperative low-dose CT matching, lateral incision, and guidewire verification.
• Final 3D scan confirms screw and cement placement; direct postoperative mobilization with full weight-bearing is initiated.

Main Results:

• 141 patients (82 ± 10 years, 89% female) with predominantly type II fragility fractures of the pelvis (FFP) were analyzed.
• Median hospital stay was 12 days; median surgery time for unilateral SI screw was 26 minutes.
• No screw loosening or migration observed; one suboptimal screw removed due to sensory impairment. Cement leakage cases were asymptomatic.

Conclusions:

• 3D robot-assisted navigation provides a safe and effective method for percutaneous sacroiliac screw fixation in dorsal fragility fractures of the pelvis.
• This technique is associated with a reduced complication rate compared to traditional methods.