Modified Jackson Transsacral Rod Fixation With True-CT Navigation for Pediatric High-Grade Dysplastic Spondylolisthesis
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Published on: October 17, 2025
Mathilde Gaumé1, Lou Davaine1, Ines Moser1
1University Institute for Spine Surgery, Armand Trousseau Hospital, Sorbonne University, 75012 Paris, France.
Background:
Modified Jackson transsacral rod fixation enables posterior-only reduction and fusion of pediatric high-grade dysplastic spondylolisthesis (PHGDS) but remains technically demanding, particularly during transsacral rod advancement through S2 in distorted sacral anatomy. After an experience of 58 fluoroscopy-guided cases, intraoperative True-CT navigation was introduced to improve control and reproducibility of this critical step.
Methods:
A fully navigated workflow using AIRO True-CT imaging was developed for pedicle screw placement, S1 screw insertion, interbody cage positioning, and transsacral rod advancement in three consecutive pediatric patients.
Results:
Navigation improved reproducibility of all implant-placement steps. Compared with historical institutional experience, operative time, blood loss, and fluoroscopy were reduced. Correction of lumbosacral kyphosis was achieved in all patients, without implant malposition or navigation-related complications.
Conclusions:
Full True-CT navigation represents the latest technical evolution of posterior-only strategy for PHSDS. This approach may improves safety, reproducibility, and operative efficiency while minimizing intraoperative radiation exposure to surgical staff.
Level Of Evidence:
IV.
