Robot-Assisted Cervical Pedicle Screw Placement: Case Series and Technical Description.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Robotics in Medicine

Background:

• Robot-assisted (RA) techniques enhance pedicle implant accuracy in thoracolumbar surgery.
• Cervical spine applications of RA techniques are less documented than thoracolumbar procedures.
• Safety and efficacy of RA cervical spine surgery require further investigation.

Purpose of the Study:

• To evaluate the safety and efficacy of robot-assisted cervical pedicle screw placement.
• To assess the accuracy of RA cervical pedicle screw placement.
• To propose a reproducible workflow for RA cervical spine surgery.

Main Methods:

• Retrospective analysis of 8 patients undergoing RA cervical pedicle screw placement (50 screws total).
• Screw placement accuracy assessed, including breach analysis.
• Specific procedural recommendations for RA cervical surgery were identified.

Main Results:

• A total of 50 cervical pedicle screws were placed across C1-C7 levels in 8 patients.
• One grade B breach occurred (C7 screw) without clinical sequelae, resulting in 98% screw accuracy.
• The study identified a high accuracy rate for RA cervical pedicle screw placement.

Conclusions:

• Robot-assisted cervical pedicle screw placement is a safe and effective adjunct for complex cervical spine procedures.
• A stepwise workflow, including Mayfield Halo and intraoperative CT, enhances reproducibility.
• Further research with larger cohorts is needed to validate long-term outcomes.