Robotic-Guided Percutaneous Pedicle Screw Implantation Using the CIRQ Robotic Alignment Module

CIRQ Robotic Alignment Module is a second-generation robotic arm from Brainlab (Munich, Germany).¹ Previous studies have described use of the first generation with the so-called passive assistance.^2-5 In this Video Article, we demonstrate robotic-guided K-wire implantation using the second generation with active assistance, followed by navigated pedicle screw implantation in lumbar spine in a patient with instability due to infection.⁶ Workflow includes preoperative screw planning, intraoperative computed tomography with automatic registration, fusion with preoperative imaging and review of the preplanned screw trajectories, robotic-assisted insertion of K-wires and navigated insertion of pedicle screws, followed by control intraoperative computed tomography scan.¹^,⁷ Our operative video adds to the growing body of literature demonstrating minimally invasive robotic assisted spinal fusion techniques (Video).⁸.