Accuracy of posterosuperior iliac spine reference array placement in robot-navigated spine surgery

Percutaneous PSIS DRB placement has poor accuracy, with skin-to-PSIS depth being a significant factor. To avoid complications from misplaced DRB placement, the authors recommend the use of DRB placement on the iliac wing, or on the PSIS, following the trajectory used in pelvis posterior column fracture fixation, using fluoroscopy intraoperatively to ensure the DRB pin position.