Neurosurgery Resident University of Miami/Jackson Health System Miami, Florida, United States
Introduction: High grade lumbosacral isthmic spondylolisthesis is a technically challenging surgical entity. Most often these patients require open invasive surgical restabilization as conservative management is limited. The continual advancement of intraoperative image guidance and robotic assisted instrumentation has aided spine surgeons in minimally invasive options for these historically open complex cases. Herein the authors present a novel minimally invasive percutaneous technique of robotic assisted navigated restabilization of high grade lumbosacral isthmic spondylolisthesis
Methods: Presented are two index cases of young patients with high grade lumbosacral isthmic spondylolisthesis that was refractory to multiple rounds of conservative therapies. They were minimally invasively treated with robotic assisted placement of a trans-sacral trans-discal screw, S2 alar screw, and trans-sacral intradiscal autograft.
Results: Utilization of preoperative robotic planning allowed for a predetermined construct that permitted for accurate percutaneous screw placement and ease of rod passage. Intraoperatively there were no complications, minimal muscle dissection, 75cc EBL, and no need for surgical drain placement. Postoperatively they were each discharged home on postoperative day 2 with minimal pain med requirements and significant improvement in their preoperative symptoms
Conclusion : Robotic assisted navigated approach is an efficacious minimally invasive option for restabilzation of high grade lumbosacral isthmic spondylolisthesis with improved clinical outcome metrics.
How to Improve Patient Care: Presents a novel minimally invasive effective alternative to a historical technically challenging and invasive surgical entity
