Synthetic CT Minimizes Radiation in Robot-Assisted Pediatric Spondylolysis and Spondylolisthesis Surgery

Cases: Three adolescent athletes ages 15 to 16 years with symptomatic L5-S1 spondylolysis and spondylolisthesis underwent surgical treatment. Two patients underwent direct pars repair, and the other patient underwent L5/S1 anterior lumbar interbody fusion with posterior percutaneous pedicle screw fixation. Robot-assisted posterior screw placement was planned and executed using MRI-generated synthetic CT (sCT). Each patient noted improvements in back pain and ambulation postoperatively. Conclusion: These are the first reported cases using sCT-guidance for robot-assisted spine surgery. This enabling technology minimizes radiation by avoiding a preoperative CT and intraoperative 3D scan.