Robot-assisted direct repair of spondylolysis

Abstract

INTRODUCTION: Direct repair of the pars defect in lumbar spondylolysis is an effective surgical procedure, but it is technically challenging. We assessed the feasibility of a new robotic system for intralaminar screw fixation of spondylolysis. PATIENT CONCERNS: A 26-year-old man complained about frequent low back pain after failed conservative treatments. DIAGNOSIS: The lumbar computed tomography images demonstrated the presence of bilateral spondylolysis at the L5 level, with no spondylolisthesis. INTERVENTIONS: We performed one surgery of direct intralaminar screw fixation under the guidance of the TiRobot system. The trajectory of the screw was planned based on intraoperative 3-dimensional radiographic images. Then, the robotic arm spontaneously moved to guide the guide wires and screw insertion. OUTCOMES: Bilateral L5 intralaminar screws were safely and accurately placed. No intraoperative complications occurred. Postoperative computed tomography showed good radiological results, without cortical perforation. CONCLUSION: We report the first case of robot-assisted direct intralaminar screw fixation for spondylolysis using the TiRobot system. Robotic guidance for direct repair of spondylolysis could be feasible.