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DSPN Spine Video Series: Surgical Video

Robot-Assisted Minimally Invasive Sacroiliac Joint Fusion for Sacroiliac Joint Dysfunction: 2-Dimensional Operative Video

Holste, Katherine G. MD; Saleh, Sara MD; Bruzek, Amy K. MD; Strong, Michael J. MD, PhD, MPH; Park, Paul MD

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doi: 10.1227/ons.0000000000000216
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Sacroiliac (SI) joint dysfunction can cause pain in the lower back, buttocks, and occasionally legs. As such, it can mimic other clinical entities such as lumbar radiculopathy or orthopedic issues. Once SI joint pain has been accurately diagnosed and patients have failed conservative treatment, fusion of the SI may be offered. The robot-assisted, minimally invasive SI joint fusion is a useful approach to fuse the SI joint with minimal damage to the superficial soft tissues.1-3 In this video, we present the case of a 68-year-old woman with persistent left-sided back, buttock, and leg pain after previous lumbar fusion. Her pain was reproduced with multiple physical exam maneuvers to elicit SI joint pain. Preoperative imaging demonstrated no hardware failure or neuroforaminal stenosis. She tried conservative therapy, which was unsuccessful. A robot-assisted, minimally invasive SI joint fusion was performed. The patient consented to the procedure. The key points of the video include patient positioning, planning screw trajectories on the robot, and placement of the screws. The patient tolerated the surgery well without any complications. She was discharged to home that same day. At the most recent follow-up, she reported relief of her back, buttock, and leg pain. The participants of this video and any identifiable individuals consented to publication of their image.

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This study did not receive any funding or financial support.


Dr Park is a consultant for Globus Medical, NuVasive, and Depuy; receives royalties from Globus Medical; and receives non–study-related clinical/research support from Depuy-Synthes, Cerapedics, SI Bone, and the International Spine Study Group (ISSG). The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.


1. De Biase G, Gassie K, Garcia D, et al. Perioperative comparison of robotic-assisted versus fluoroscopically guided minimally invasive transforaminal lumbar interbody fusion. World Neurosurg. 2021;149(suppl 1):e570-e575.
2. Fu W, Tong J, Liu G, et al. Robot-assisted technique vs conventional freehand technique in spine surgery: a meta-analysis. Int J Clin Pract. 2021;75(5):e13964.
3. D'Souza M, Gendreau J, Feng A, Kim LH, Ho AL, Veeravagu A. Robotic-assisted spine surgery: history, efficacy, cost, and future trends. Robot Surg. 2019;6:9-23; Erratum: Robot Surg. 2019;6:25.

Sacroiliac joint fusion; Minimally invasive neurosurgery; Robot-assisted neurosurgery; SI joint dysfunction

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