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Updated: Jun 15, 2025
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A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
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Robotic-assisted ilio-sacral screws in vertically-unstable sacral fractures
Madhava Pai1,2, S Vidyadhara1,2, T Balamurugan1
1Manipal Institute of Robotic Spine Surgery, Manipal Comprehensive Spine Care Center, Manipal Hospital, Bangalore, India.
Journal of Clinical Orthopaedics and Trauma
|June 13, 2025
Summary
Robotic assistance enhances iliosacral screw placement for pelvic fractures, overcoming anatomical challenges. This technical note details a novel workflow for the MazorX Stealth Edition system, improving surgical precision and confidence.
Area of Science:
- Orthopedic Surgery
- Medical Robotics
- Spinal Surgery
Background:
- Posterior pelvic stabilization using iliosacral screws presents anatomical challenges, including narrow safe corridors and proximity to vital structures.
- Traditional fluoroscopic guidance offers limited visualization of these complex 3D bony pathways on 2D imaging.
Observation:
- This technical note describes the first use of the MazorX Stealth Edition (MXSE) robotic system for percutaneous iliosacral screw fixation in two patients with vertically unstable sacral fractures.
- The workflow involved robotic-guided drilling of trajectories using intraoperative 3D computed tomography (CT) scans for precise screw placement.
Findings:
- Two 6.5mm cannulated cancellous iliosacral screws were successfully placed percutaneously in each patient via the ilium-S1/S2 corridor.
- Robotic assistance facilitated accurate trajectory planning and execution, addressing the limitations of conventional fluoroscopic guidance.
Implications:
- This demonstrates a viable robotic-assisted workflow for iliosacral screw fixation using the MXSE system, expanding its application in complex pelvic fracture management.
- Robotic surgery offers enhanced visualization, improved understanding of complex anatomy, and increased surgeon confidence for unconventional surgical approaches.
