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. 2025 Jul 1;13(1):V8.
doi: 10.3171/2025.4.FOCVID255. eCollection 2025 Jul.

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

Pradeep Vitta  1 , Abhishek Soni  1 , Balamurugan Thirugnanam  1 , Madhava Pai Kanhangad  2 , Vidyadhara Srinivasa  1
Affiliations

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

Pradeep Vitta et al. Neurosurg Focus Video. .

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.

Keywords: S2AI screw placement; innovations in robotic sacropelvic fusion; robot-guided percutaneous fixation; sacral alar fixation; spinal robotics evolution.

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Conflict of interest statement

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this publication.The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this publication.

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