Technical nuances of robotic-guided S2 alar-iliac screw insertion

Abstract

Robot-assisted S2-alar-iliac (S2AI) screw placement enhances accuracy and minimizes complications in spinal deformity and pelvic fixation surgeries. This video outlines the intraoperative navigation, planning, and execution of S2AI screw placement using robotic guidance. By optimizing screw trajectory and reducing soft-tissue disruption, robotic assistance improves biomechanical stability in long-segment spinopelvic constructs. The integration of real-time navigation enhances precision, potentially lowering revision rates. This video aims to highlight the technical nuances, clinical advantages, and outcomes associated with robot-assisted S2AI screw placement, underscoring its role in advancing spine surgery with greater consistency and safety. The video can be found here: https://stream.cadmore.media/r10.3171/2025.4.FOCVID255.