Robotic-Assisted Fixation and Cementation for Sacral Insufficiency Fractures: A Case Series and Technical Note

Area of Science:

• Orthopedic Surgery
• Robotics in Medicine
• Geriatric Fractures

Background:

• Sacral insufficiency fractures are increasing in the aging population.
• Early surgical fixation is gaining traction but faces technical challenges with traditional methods.
• Robotic-assisted surgery presents a novel solution for spinal and pelvic procedures.

Purpose of the Study:

• To evaluate the safety and efficacy of robotic-assisted sacroiliac screw fixation with cement augmentation for sacral insufficiency fractures.
• To assess outcomes including surgical time, radiation exposure, complications, and patient mobilization.

Main Methods:

• Retrospective analysis of five patients with sacral insufficiency fractures unresponsive to non-operative management.
• Utilized the Mazor X robotic system for CT-planned, guided placement of fenestrated sacroiliac screws.
• Performed cement augmentation post-screw placement.

Main Results:

• Mean operative time was 36 minutes with a median of 13 fluoroscopy shots.
• All patients experienced significant pain relief and mobilized on postoperative day 1.
• No operative or postoperative complications were observed in the cohort.

Conclusions:

• Robotic-assisted percutaneous sacroiliac fixation with cement augmentation is a safe, efficient, and minimally invasive treatment option.
• The robotic system's precision ensures stable fixation, leading to immediate pain relief and early mobilization.
• Further research is warranted to confirm these promising findings in larger patient cohorts.