Robot-assisted percutaneous pars-pedicle screw fixation for treating Hangman's fracture

This study aimed to evaluate the safety and efficacy of robot-assisted percutaneous pars-pedicle screw fixation surgery for treating Hangman's fracture. The study involved 33 patients with Hangman's fracture who underwent robot-assisted fixation surgery using cannulated pars-pedicle screws through a percutaneous approach. The primary parameter evaluated was the accuracy of the screws according to the Gertzbein-Robbins scale, using postoperative CT images. Secondary parameters included the duration of surgery, intraoperative blood loss, postoperative hospital stay, and neurovascular injury. A total of 60 pars-pedicle screws were placed in 33 patients. Based on the Levine and Edwards classification, the patients included 12 cases of type I, 15 cases of type II, five cases of type IIa, and one atypical case. The average operative time was 92.4 ± 37.4 min, and the average blood loss was 22.4 ± 17.9 ml. Fifty-five of 60 screws were successfully placed within the bone. No screw-related neurovascular injury was observed, and satisfactory reduction was achieved in all cases. Robot-assisted percutaneous pars-pedicle screw fixation is a safe and feasible method for treating Hangman's fracture. The study was retrospectively registered and approved by our center's institutional review board.