2024, Vol. 28 ›› Issue (24): 3845-3849

Accuracy of sacroiliac screw placement in robot-assisted navigation

Zhang Wenhui1, Wang Chunli2, Fan Lizhen1, Yang Yuping1, Zhang Jinlong3, Zhang Hui1, Liu Jie4, Tai Huiping1   

Abstract: BACKGROUND: Orthopedic robots have been widely used in clinical practice, and relevant reports have shown that they have many advantages such as minimal trauma and short surgical time. However, there is currently no clear report on how accurate they are.
OBJECTIVE: To evaluate the accuracy of robot-assisted sacroiliac screw insertion.
METHODS: A total of 131 patients with sacroiliac joint fracture and dislocation and sacral fracture admitted to the Department of Trauma Surgery, Gansu Provincial Hospital from January 2020 to April 2023 were retrospectively collected, including 131 S1 screws and 46 S2 screws, totaling 177 screws. They were divided into two groups based on whether robot-assisted navigation was performed. There were 63 cases of sacroiliac screws inserted under robot-assisted navigation (observation group), with 36 males and 27 females, aged 19-72 years, with a mean age of (45.3±17.6) years. Among them, 39 cases were fixed with only S1 screws, while 24 cases were fixed with S1S2 screws, resulting in a total of 87 sacroiliac screws. Under C-arm fluoroscopy, 68 cases of sacroiliac screws were inserted with bare hands (control group), including 41 males and 27 females, aged 23-67 years, with a mean age of (42.6±21.3) years. Among them, 46 cases were fixed with simple S1 screws, while 22 cases were fixed with S1S2 screws, resulting in a total of 90 sacroiliac screws. A postoperative CT scan was performed to evaluate the number of S1 screws, S2 screws, total screw level, and calculate accuracy based on the method introduced by SMITH et al.
RESULTS AND CONCLUSION: (1) In the observation group, 62 S1 screws were accurately placed (62/63), with an accuracy rate of 98%. 24 S2 screws were accurately placed (24/24), with an accuracy rate of 100%. The total number of screws accurately placed was 86 (86/87), with an accuracy rate of 99%. (2) In the control group, 58 S1 screws were accurately inserted (58/68), with an accuracy rate of 85%. 19 S2 screws were accurately inserted (19/22), with an accuracy rate of 86%. The total number of screws accurately inserted was 77 (77/90), with an accuracy rate of 86%. (3) There was a statistically significant difference in the accuracy of the S1 screw, S2 screw, and total screw between the two groups (P < 0.05). It is suggested that the placement of sacroiliac screws under robot navigation has higher accuracy compared to manual placement under C-arm fluoroscopy, but still has a lower error rate in placement.

Key words: robot-assisted, sacroiliac screw, sacroiliac joint fracture and dislocation, sacral fracture, screw placement, accuracy rate, posterior pelvic ring