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Updated: Sep 16, 2025

A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
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Robotic-Guided Spine Surgery: Implementation of a System in Routine Clinical Practice-An Update.

Mirza Pojskić1, Miriam Bopp1,2, Omar Alwakaa1

  • 1Department of Neurosurgery, University of Marburg, 35043 Marburg, Germany.

Journal of Clinical Medicine
|July 12, 2025
PubMed
Summary
This summary is machine-generated.

Robotic-guided spine surgery using intraoperative CT navigation achieved high accuracy for pedicle screw placement in 108 patients. The study demonstrates a learning curve with improved robotic times and efficiency over the course of the surgeries.

Keywords:
intraoperative computer tomographyneuronavigationpedicle screwsrobotic-guided spine surgery

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Medical Technology

Background:

  • Robotic-guided (RG) spine surgery integration into clinical practice is evolving.
  • Intraoperative CT (iCT) with automatic registration enhances navigation accuracy.
  • Standardized workflows are crucial for adopting new surgical technologies.

Purpose of the Study:

  • To present the initiation of robotic-guided spine surgery in routine clinical care.
  • To evaluate the accuracy and efficiency of robotic-guided pedicle screw placement using iCT navigation.
  • To assess the learning curve associated with this new surgical approach.

Main Methods:

  • A single-center study included 108 patients undergoing RG pedicle screw implantation in the thoracolumbar spine.
  • The workflow involved iCT with automatic registration, navigation, and robotic arm guidance.
  • Pedicle screw accuracy was evaluated using the Gertzbein-Robbins scale (GRS).

Main Results:

  • Out of 688 pedicle screws placed, 86.1% were GRS A (optimal accuracy).
  • Mean operation time was 228.8 minutes, with a mean robotic time of 31.5 minutes.
  • Improvements in robotic time and time per K-wire insertion indicated a learning curve.

Conclusions:

  • Robotic-guided pedicle screw placement in the thoracolumbar spine demonstrates high accuracy.
  • The Cirq® Robotic Alignment Module facilitates precise screw insertion.
  • Surgical efficiency improves over time, highlighting a significant learning curve.