Robotic-guided percutaneous pedicle screw implantation using CIRQ Robotic Alignment Module.

CIRQ® Robotic Alignment Module is a second generation of Brainlab® (Munich, Germany) robotic arm (1). Previous studies have described use of the first generation with the so called passive assistance (2-5). In this operative video we demonstrate robotic-guided K-wire implantation using 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, iCT 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 iCT scan(1, 7). Our operative video adds to the growing body of literature demonstrating minimally invasive robotic assisted spinal fusion techniques(8).