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Robotic-Assisted C2 Laminar Screw Placement: Initial Experience and Accuracy Evaluation.

Yuki Yamamoto1, Takashi Fujishiro1, Fumiya Adachi1

  • 1Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.

Journal of Neurological Surgery. Part A, Central European Neurosurgery
|March 25, 2026
PubMed
Summary

Robotic systems (RS) show promise for accurate C2 laminar screw (LS) placement in cervical spine fusion. This study found RS-assisted C2 LS placement to be safe and precise, with minimal deviations.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Fusion Techniques

Background:

  • C2 laminar screw (LS) is a stable alternative to C2 pedicle screw (PS) in cervical fusion.
  • Accurate C2 LS placement is crucial to avoid neural injury and ensure fixation.
  • Robotic systems (RS) are emerging tools for enhancing surgical accuracy.

Purpose of the Study:

  • To evaluate the accuracy of C2 LS placement using robotic system (RS) assistance.
  • To assess the safety and efficacy of RS-assisted C2 LS insertion in cervical fusion.

Main Methods:

  • Prospective study involving 11 patients undergoing cervical fusion.
  • 11 C2 laminar screws (LS) were placed with RS assistance.
  • Surgical outcomes and screw placement accuracy were assessed.

Main Results:

  • All 11 C2 LSs were successfully placed without complications.
  • No cortical breaches or screw-related issues were observed.
  • Mean deviations at entry point and depth were under 1.0 mm in axial and sagittal planes.

Conclusions:

  • Robotic system (RS) assistance facilitates accurate C2 LS placement.
  • RS shows potential as a valuable tool for precise C2 LS insertion in clinical practice.