Sacroiliac Joint Fusion: A Comparison Between Robotic Guidance Fusion and Minimally Invasive Navigation Fusion

Background and objective Sacroiliac joint (SIJ) dysfunction, a frequently underdiagnosed cause of low back pain, remains relatively understudied. Minimally invasive methods, including navigation and robotic technology, are gaining popularity due to their lower surgical risks. This study aimed to compare outcomes of navigation-assisted (NA) SIJ fusion and robotic-assisted (RA) SIJ fusion performed at our institution. Methods We retrospectively reviewed adult patients who underwent SIJ fusion between November 2022 and September 2024. Details of demographic data, operative details (OR time, screw placement accuracy), postoperative complications, and pain scores (preoperative, postoperative) were collected. Changes in pain scores and surgical metrics were compared between the NA and RA groups. Results Our study included 31 patients who underwent SIJ fusion during the study period: 19 with NA and 12 with RA. Both cohorts were comparable at baseline in age (p=0.416), BMI (p=0.478), and prior surgeries (p=0.879). The group comprised 21 females and 10 males, with an average age of 65.5 years. Operative time was significantly longer in the RA group (p<0.001). Regarding screw placement accuracy, no intraoperative screw misplacements occurred in either group. The NA cohort had 10.3% improvement in their pain scores within 30 days postoperatively, while the RA group had 31.0% improvement (p=0.52). No postoperative complication necessitating a revision surgery occurred in the patient cohort. Two hardware failures (screw fractures) were observed in the NA group without worsening of symptoms. Long-term pain outcomes were also comparable, showing an improvement of around 5% in the RA group and 62% in the NA group (p=0.083). Conclusions While there was no statistically significant difference between the groups, a trend toward lower postoperative pain scores was observed in the RA group. The extended operative time in the RA group is attributable to the new technique at our hospital.