ORTHOPEDICS: Edited by Daniel GreenAdvances in robotics and pediatric spine surgeryCirrincione, Peter; Widmann, Roger F.; Heyer, Jessica H. Author Information Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA Correspondence to Jessica H. Heyer, MD, Department of Pediatric Orthopaedic Surgery, 535 East 70th St, New York, NY 10021, USA. Tel: +1 212 774 2677; e-mail: [email protected] Current Opinion in Pediatrics 35(1):p 102-109, February 2023. | DOI: 10.1097/MOP.0000000000001199 Buy Metrics Abstract Purpose of review Robotic-assisted surgical navigation for placement of pedicle screws is one of the most recent technological advancements in spine surgery. Excellent accuracy and reliability results have been documented in the adult population, but adoption of robotic surgical navigation is uncommon in pediatric spinal deformity surgery. Pediatric spinal anatomy and the specific pediatric pathologies present unique challenges to adoption of robotic assisted spinal deformity workflows. The purpose of this article is to review the safety, accuracy and learning curve data for pediatric robotic-assisted surgical navigation as well as to identify “best use” cases and technical tips. Recent findings Robotic navigation has been demonstrated as a safe, accurate and reliable method to place pedicle screws in pediatric patients with a moderate learning curve. There are no prospective studies comparing robotically assisted pedicle screw placement with other techniques for screw placement, however several recent studies in the pediatric literature have demonstrated high accuracy and safety as well as high reliability. In addition to placement of pediatric pedicle screws in the thoracic and lumbar spine, successful and safe placement of screws in the pelvis and sacrum have also been reported with reported advantages over other techniques in the setting of high-grade spondylolisthesis as well as pelvic fixation utilizing S2-alar iliac (S2AI) screws. Summary Early studies have demonstrated that robotically assisted surgical navigation for pedicle screws and pelvic fixation for S2AI screws is safe, accurate, and reliable in the pediatric population with a moderate learning curve. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.