Robot-assisted MIS transiliac sacroiliac joint fusion: Technical note - 06/09/25

Doi : 10.1016/j.neuchi.2025.101715

A. Nguyen ^a,⁎ , P. Haettel ^a,^b, B. Ghannam ^a, R. Assaker ^a, H.-A. Leroy ^a,^b,^c,^d
^a CHU Lille, Neurochirurgie, F-59000 Lille, France
^b Univ Lille, UMR 9189 - CRIStAL - Centre de Recherche en Informatique, Signal et Automatique de Lille, INRIA, CNRS, Centrale Lille, Lille, France
^c AO Spine, Chairman for France, 7270 Davos, Switzerland
^d Head of Innovation Commission for the French Society of Spine Surgery (SFCR)

^⁎Corresponding author.

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Highlights

•	First description of robot-assisted transiliac sacroiliac joint fusion using the MazorX system with triangular titanium implants (iFuse).
•	Preoperative CT-based trajectory planning allows precise implant positioning and optimizes skin incision.
•	Intraoperative fluoroscopy limited to coregistration and final verification allows reduction of radiation exposure for patient and staff.
•	The technique permitted in our case immediate pain relief, same-day ambulation, and sustained symptom resolution at 14-month follow-up without any complication.

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Abstract

Background

Sacroiliac joint dysfunction (SIJD) accounts for 15–25% of chronic low back pain and often follows lumbar fusion. When conservative therapies fail, minimally invasive (MIS) SIJ fusion (SIJF) is indicated. The robot-assisted technique is feasible and safe, enhancing accuracy and reducing radiation exposure.

Case description

A 26-year-old woman, eight years after L4-S1 fusion, presented with bilateral SIJD refractory to physiotherapy and intraarticular steroids injection. SIJF was indicated. Here we describe the robot-assisted technique and its advantages.

Conclusion

Robot-assisted SIJF is a safe and accurate technique to treat SIJD while reducing radiation exposure. Trajectories planification and consideration of anatomical variations give the robot-assisted technique an advantage over conventional techniques such as fluoroscopy or navigation.

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Keywords : Sacroiliac joint dysfunction, Robot-assisted, Robotic, Minimally invasive sacroiliac joint fusion, Low back pain, Transiliac sacroiliac joint fusion