Robotic-Guided Percutaneous Pedicle Screw Implantation Using the CIRQ Robotic Alignment Module

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Medical Robotics

Background:

• First-generation robotic arms utilized passive assistance for spinal procedures.
• Minimally invasive spinal surgery aims to reduce patient trauma and recovery time.

Purpose of the Study:

• To demonstrate robotic-guided K-wire and pedicle screw implantation in the lumbar spine using the second-generation CIRQ Robotic Alignment Module with active assistance.
• To showcase a minimally invasive robotic-assisted spinal fusion technique for treating lumbar instability due to infection.

Main Methods:

• The workflow involved preoperative planning, intraoperative computed tomography (CT) with automatic registration, and fusion with preoperative imaging.
• Robotic-assisted K-wire insertion and navigated pedicle screw implantation were performed, followed by a control intraoperative CT scan.
• The procedure was demonstrated in a patient with lumbar spine instability caused by infection.

Main Results:

• Successful robotic-guided K-wire implantation was achieved.
• Navigated pedicle screw implantation in the lumbar spine was successfully performed.
• The technique was applied to a patient with instability due to infection, demonstrating feasibility.

Conclusions:

• The second-generation CIRQ Robotic Alignment Module enables robotic-guided K-wire and navigated pedicle screw implantation with active assistance.
• This robotic-assisted approach represents a viable minimally invasive technique for spinal fusion, particularly in complex cases like infection-related instability.
• The study contributes to the literature on advanced robotic applications in spine surgery.