Mazor X robot-assisted upper and lower cervical pedicle screw fixation: a case report and literature review

Abstract Background: Manual placement of cervical pedicle screws is risky, and robot-assisted placement of atlantoaxial pedicle screws has not been reported. Case report: We describe a 74-year-old female patient with atlantoaxial fracture and dislocation combined with spinal cord injury caused by a car accident. The left lower limb muscle strength was grade 0, the right upper limb muscle strength was grade 1, and the right lower limb muscle strength was grade 2. Loss of sensation below the clavicle level, decreased superficial sensation in the extremities, loss of deep sensation in the left lower extremity, and incontinence were observed. We successfully placed atlas pedicle screws with the assistance of the Mazor X robot. One week after the operation, radiological imaging revealed that the reduction effect was good, the placement of the pedicle screws was satisfactory, the left upper limb and left lower limb muscle strength was level 2, the right upper limb and the muscle strength of the right lower limb were grade 3, and the sensory function was partially restored. No complications related to screw placement were found at the 3-month postoperative follow-up. Conclusions: Mazor X robot-assisted descending pedicle screw fixation of the atlas is feasible and safe.