Background: The anchor at C2 often serves as a key stabilizer in cervical spine fusion surgery. Although the pedicle screw (PS) is considered the standard fixation method at C2, the laminar screw (LS) is also a widely used alternative due to its biomechanical stability, comparable to that of C2 PS. However, malpositioning of C2 LS carries a risk of neural injury and compromised fixation stability, and the use of surgical assistance has been reported to improve placement accuracy. The robotic system (RS) is a relatively new technology for PS placement, and its application has recently expanded to the cervical spine. The present study aimed to investigate the accuracy of C2 LS placement with RS assistance. Methods: This prospective study evaluated 11 C2 LSs in 11 patients who underwent cervical fusion surgery with the RS assistance between March 2024 and June 2025 (11 patients, 11 C2 LSs). Results: All 11 C2 LSs were successfully placed with no cortical breaches and no screw-related complications. The mean deviations at both the entry point and at a depth of 20 mm were less than 1.0 mm in both the axial and sagittal planes. Conclusions: The results of this study suggest that the RS is a potential tool to facilitate accurate C2 LS placement in clinical settings.
Yamamoto et al. (Wed,) studied this question.