{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T22:42:51Z","timestamp":1781476971506,"version":"3.54.1"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"11","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,9,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Robot-assisted techniques are increasingly integrated into the field of spine surgery, with the potential benefits of increased accuracy and reduced radiation exposure. The objective of this study was to describe the technique of minimally invasive robot-assisted direct pars repair with 2 case illustrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>An 18-year-old male and a 42-year-old male, both with bilateral L5 spondylolysis, underwent successful minimally invasive L5 direct pars repairs with robotic assistance after conservative measures failed, and their cases are presented herein.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>A robot-assisted direct pars repair is a safe and effective technique for treating bilateral lumbar spondylolysis. The integration of robot-assisted techniques in spine surgery has the potential to improve outcomes, decrease surgical time, and reduce the amount of radiation exposure to operating room staff.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE2415\">https:\/\/thejns.org\/doi\/10.3171\/CASE2415<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case2415","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T03:29:14Z","timestamp":1725852554000},"source":"Crossref","is-referenced-by-count":2,"title":["Minimally invasive robot-assisted direct pars repair: illustrative cases"],"prefix":"10.3171","volume":"8","author":[{"given":"Jeffrey J","family":"Stewart","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Y","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gnel","family":"Pivazyan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Gensler","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Marc","family":"Voyadzis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"bib1","series-title":"J Neurosurg Spine","first-page":"299","article-title":"Robot-assisted and augmented reality\u2013assisted spinal instrumentation: a systematic review and meta-analysis of screw accuracy and outcomes over the last decade","volume":"37","author":"Tovar","year":"2022","unstructured":"Tovar MADowlati EZhao DY, et al. Robot-assisted and augmented reality\u2013assisted spinal instrumentation: a systematic review and meta-analysis of screw accuracy and outcomes over the last decade. J Neurosurg Spine. 2022;37(2):299-314."},{"issue":"suppl","key":"bib2","series-title":"Neurosurgery","first-page":"12","article-title":"Spinal robotics: current applications and future perspectives","volume":"72","author":"Roser","year":"2013","unstructured":"Roser FTatagiba MMaier G. Spinal robotics: current applications and future perspectives. Neurosurgery. 2013;72(suppl 1):12-18."},{"issue":"6","key":"bib3","series-title":"J Spinal Disord Tech","first-page":"324","article-title":"Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients","volume":"25","author":"Wang","year":"2012","unstructured":"Wang MYLerner JLesko JMcGirt MJ. Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients. J Spinal Disord Tech. 2012;25(6):324-328."},{"issue":"4","key":"bib4","series-title":"J Neurosurg Spine","first-page":"471","article-title":"Surgical site infection rates after minimally invasive spinal surgery","volume":"11","author":"O\u2019Toole","year":"2009","unstructured":"O\u2019Toole JEEichholz KMFessler RG. Surgical site infection rates after minimally invasive spinal surgery. J Neurosurg Spine. 2009;11(4):471-476."},{"issue":"6","key":"bib5","series-title":"Oper Neurosurg (Hagerstown)","first-page":"750","article-title":"The difference in surgical site infection rates between open and minimally invasive spine surgery for degenerative lumbar pathology: a retrospective single center experience of 1442 cases","volume":"16","author":"Mueller","year":"2019","unstructured":"Mueller KZhao DJohnson OSandhu FAVoyadzis JM. The difference in surgical site infection rates between open and minimally invasive spine surgery for degenerative lumbar pathology: a retrospective single center experience of 1442 cases. Oper Neurosurg (Hagerstown). 2019;16(6):750-755."},{"issue":"3","key":"bib6","series-title":"Tech Orthop","first-page":"272","article-title":"Robotic-assisted spine surgery: a review of its development, outcomes, and economics on practice","volume":"36","author":"Kia","year":"2021","unstructured":"Kia CEsmende S. Robotic-assisted spine surgery: a review of its development, outcomes, and economics on practice. Tech Orthop. 2021;36(3):272-276."},{"issue":"4","key":"bib7","series-title":"Med (Baltim)","first-page":"e18944","article-title":"Robot-assisted direct repair of spondylolysis: a case report","volume":"99","author":"Tian","year":"2020","unstructured":"Tian WZhang QHan XGYuan QHe DLiu YJ. Robot-assisted direct repair of spondylolysis: a case report. Med (Baltim). 2020;99(4):e18944."},{"key":"bib8","series-title":"World Neurosurg","first-page":"e492","article-title":"Robot-assisted percutaneous pedicle screw placement: evaluation of accuracy of the first 100 screws and comparison with cohort of fluoroscopy-guided screws","volume":"143","author":"Fayed","year":"2020","unstructured":"Fayed ITai ATriano M, et al. Robot-assisted percutaneous pedicle screw placement: evaluation of accuracy of the first 100 screws and comparison with cohort of fluoroscopy-guided screws. World Neurosurg. 2020;143:e492-e502."},{"issue":"2","key":"bib9","series-title":"Neurosurg Focus","first-page":"E13","article-title":"Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects","volume":"25","author":"Brennan","year":"2008","unstructured":"Brennan RPSmucker PYHorn EM. Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects. Neurosurg Focus. 2008;25(2):E13."},{"issue":"5","key":"bib10","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes","volume":"31","author":"Drazin","year":"2011","unstructured":"Drazin DShirzadi AJeswani S, et al. Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes. Neurosurg Focus. 2011;31(5):E9."},{"issue":"5","key":"bib11","series-title":"J Bone Joint Surg Am","first-page":"699","article-title":"The natural history of spondylolysis and spondylolisthesis","volume":"66","author":"Fredrickson","year":"1984","unstructured":"Fredrickson BEBaker DMcHolick WJYuan HALubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am. 1984;66(5):699-707."},{"issue":"2","key":"bib12","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Minimally invasive direct pars repair with cannulated screws and recombinant human bone morphogenetic protein: case series and review of the literature","volume":"43","author":"Ghobrial","year":"2017","unstructured":"Ghobrial GMCrandall KMLau AWilliams SKLevi AD. Minimally invasive direct pars repair with cannulated screws and recombinant human bone morphogenetic protein: case series and review of the literature. Neurosurg Focus. 2017;43(2):E6."},{"issue":"1","key":"bib13","series-title":"Neurosurg Focus","first-page":"E10","article-title":"A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis","volume":"44","author":"Mohammed","year":"2018","unstructured":"Mohammed NPatra DPNarayan V, et al. A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis. Neurosurg Focus. 2018;44(1):E10."},{"key":"bib14","series-title":"Case Rep Med","first-page":"659078","article-title":"Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes","volume":"2013","author":"Widi","year":"2013","unstructured":"Widi GAWilliams SKLevi AD. Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes. Case Rep Med. 2013;2013:659078."},{"key":"bib15","series-title":"World Neurosurg","first-page":"181","article-title":"Success and failure of percutaneous minimally invasive direct pars repair: analysis of fracture morphology","volume":"126","author":"Fayed","year":"2019","unstructured":"Fayed IConte AGVoyadzis JM. Success and failure of percutaneous minimally invasive direct pars repair: analysis of fracture morphology. World Neurosurg. 2019;126:181-188."},{"issue":"2","key":"bib16","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct","volume":"25","author":"Noggle","year":"2008","unstructured":"Noggle JCSciubba DMSamdani AFAnderson DGBetz RRAsghar J. Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct. Neurosurg Focus. 2008;25(2):E15."},{"issue":"5","key":"bib17","series-title":"Asian Spine J","first-page":"832","article-title":"Minimally-invasive versus conventional repair of spondylolysis in athletes: a review of outcomes and return to play","volume":"11","author":"Kolcun","year":"2017","unstructured":"Kolcun JPGChieng LOMadhavan KWang MY. Minimally-invasive versus conventional repair of spondylolysis in athletes: a review of outcomes and return to play. Asian Spine J. 2017;11(5):832-842."},{"issue":"suppl","key":"bib18","series-title":"Spine (Phila Pa 1976)","first-page":"B6","article-title":"Direct repair of lumbar pars interarticularis defects by utilizing intraoperative O-arm-based navigation and microendoscopic techniques","volume":"41","author":"Jia","year":"2016","unstructured":"Jia MWang JZhang ZZheng WZhou Y. Direct repair of lumbar pars interarticularis defects by utilizing intraoperative O-arm-based navigation and microendoscopic techniques. Spine (Phila Pa 1976). 2016;41(suppl 19):B6-B13."},{"issue":"1","key":"bib19","series-title":"Neurosurg Rev","first-page":"20","article-title":"Basis for error in stereotactic and computer-assisted surgery in neurosurgical applications: literature review","volume":"46","author":"Pivazyan","year":"2022","unstructured":"Pivazyan GSandhu FABeaufort ARCunningham BW. Basis for error in stereotactic and computer-assisted surgery in neurosurgical applications: literature review. Neurosurg Rev. 2022;46(1):20."},{"issue":"7","key":"bib20","series-title":"Glob Spine J","first-page":"814","article-title":"Assessment of surgical procedural time, pedicle screw accuracy, and clinician radiation exposure of a novel robotic navigation system compared with conventional open and percutaneous freehand techniques: a cadaveric investigation","volume":"10","author":"Vaccaro","year":"2020","unstructured":"Vaccaro ARHarris JAHussain MM, et al. Assessment of surgical procedural time, pedicle screw accuracy, and clinician radiation exposure of a novel robotic navigation system compared with conventional open and percutaneous freehand techniques: a cadaveric investigation. Glob Spine J. 2020;10(7):814-825."},{"key":"bib21","series-title":"Robot Surg","first-page":"9","article-title":"Robotic-assisted spine surgery: history, efficacy, cost, and future trends","volume":"6","author":"D\u2019Souza","year":"2019","unstructured":"D\u2019Souza MGendreau JFeng AKim LHHo ALVeeravagu A. Robotic-assisted spine surgery: history, efficacy, cost, and future trends. Robot Surg. 2019;6:9-23."},{"issue":"2","key":"bib1","series-title":"J Neurosurg Spine","first-page":"299","article-title":"Robot-assisted and augmented reality\u2013assisted spinal instrumentation: a systematic review and meta-analysis of screw accuracy and outcomes over the last decade","volume":"37","author":"Tovar","year":"2022","unstructured":"Tovar MADowlati EZhao DY, et al. Robot-assisted and augmented reality\u2013assisted spinal instrumentation: a systematic review and meta-analysis of screw accuracy and outcomes over the last decade. J Neurosurg Spine. 2022;37(2):299-314."},{"issue":"suppl","key":"bib2","series-title":"Neurosurgery","first-page":"12","article-title":"Spinal robotics: current applications and future perspectives","volume":"72","author":"Roser","year":"2013","unstructured":"Roser FTatagiba MMaier G. Spinal robotics: current applications and future perspectives. Neurosurgery. 2013;72(suppl 1):12-18."},{"issue":"6","key":"bib3","series-title":"J Spinal Disord Tech","first-page":"324","article-title":"Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients","volume":"25","author":"Wang","year":"2012","unstructured":"Wang MYLerner JLesko JMcGirt MJ. Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients. J Spinal Disord Tech. 2012;25(6):324-328."},{"issue":"4","key":"bib4","series-title":"J Neurosurg Spine","first-page":"471","article-title":"Surgical site infection rates after minimally invasive spinal surgery","volume":"11","author":"O\u2019Toole","year":"2009","unstructured":"O\u2019Toole JEEichholz KMFessler RG. Surgical site infection rates after minimally invasive spinal surgery. J Neurosurg Spine. 2009;11(4):471-476."},{"issue":"6","key":"bib5","series-title":"Oper Neurosurg (Hagerstown)","first-page":"750","article-title":"The difference in surgical site infection rates between open and minimally invasive spine surgery for degenerative lumbar pathology: a retrospective single center experience of 1442 cases","volume":"16","author":"Mueller","year":"2019","unstructured":"Mueller KZhao DJohnson OSandhu FAVoyadzis JM. The difference in surgical site infection rates between open and minimally invasive spine surgery for degenerative lumbar pathology: a retrospective single center experience of 1442 cases. Oper Neurosurg (Hagerstown). 2019;16(6):750-755."},{"issue":"3","key":"bib6","series-title":"Tech Orthop","first-page":"272","article-title":"Robotic-assisted spine surgery: a review of its development, outcomes, and economics on practice","volume":"36","author":"Kia","year":"2021","unstructured":"Kia CEsmende S. Robotic-assisted spine surgery: a review of its development, outcomes, and economics on practice. Tech Orthop. 2021;36(3):272-276."},{"issue":"4","key":"bib7","series-title":"Med (Baltim)","first-page":"e18944","article-title":"Robot-assisted direct repair of spondylolysis: a case report","volume":"99","author":"Tian","year":"2020","unstructured":"Tian WZhang QHan XGYuan QHe DLiu YJ. Robot-assisted direct repair of spondylolysis: a case report. Med (Baltim). 2020;99(4):e18944."},{"key":"bib8","series-title":"World Neurosurg","first-page":"e492","article-title":"Robot-assisted percutaneous pedicle screw placement: evaluation of accuracy of the first 100 screws and comparison with cohort of fluoroscopy-guided screws","volume":"143","author":"Fayed","year":"2020","unstructured":"Fayed ITai ATriano M, et al. Robot-assisted percutaneous pedicle screw placement: evaluation of accuracy of the first 100 screws and comparison with cohort of fluoroscopy-guided screws. World Neurosurg. 2020;143:e492-e502."},{"issue":"2","key":"bib9","series-title":"Neurosurg Focus","first-page":"E13","article-title":"Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects","volume":"25","author":"Brennan","year":"2008","unstructured":"Brennan RPSmucker PYHorn EM. Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects. Neurosurg Focus. 2008;25(2):E13."},{"issue":"5","key":"bib10","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes","volume":"31","author":"Drazin","year":"2011","unstructured":"Drazin DShirzadi AJeswani S, et al. Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes. Neurosurg Focus. 2011;31(5):E9."},{"issue":"5","key":"bib11","series-title":"J Bone Joint Surg Am","first-page":"699","article-title":"The natural history of spondylolysis and spondylolisthesis","volume":"66","author":"Fredrickson","year":"1984","unstructured":"Fredrickson BEBaker DMcHolick WJYuan HALubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am. 1984;66(5):699-707."},{"issue":"2","key":"bib12","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Minimally invasive direct pars repair with cannulated screws and recombinant human bone morphogenetic protein: case series and review of the literature","volume":"43","author":"Ghobrial","year":"2017","unstructured":"Ghobrial GMCrandall KMLau AWilliams SKLevi AD. Minimally invasive direct pars repair with cannulated screws and recombinant human bone morphogenetic protein: case series and review of the literature. Neurosurg Focus. 2017;43(2):E6."},{"issue":"1","key":"bib13","series-title":"Neurosurg Focus","first-page":"E10","article-title":"A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis","volume":"44","author":"Mohammed","year":"2018","unstructured":"Mohammed NPatra DPNarayan V, et al. A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis. Neurosurg Focus. 2018;44(1):E10."},{"key":"bib14","series-title":"Case Rep Med","first-page":"659078","article-title":"Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes","volume":"2013","author":"Widi","year":"2013","unstructured":"Widi GAWilliams SKLevi AD. Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes. Case Rep Med. 2013;2013:659078."},{"key":"bib15","series-title":"World Neurosurg","first-page":"181","article-title":"Success and failure of percutaneous minimally invasive direct pars repair: analysis of fracture morphology","volume":"126","author":"Fayed","year":"2019","unstructured":"Fayed IConte AGVoyadzis JM. Success and failure of percutaneous minimally invasive direct pars repair: analysis of fracture morphology. World Neurosurg. 2019;126:181-188."},{"issue":"2","key":"bib16","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct","volume":"25","author":"Noggle","year":"2008","unstructured":"Noggle JCSciubba DMSamdani AFAnderson DGBetz RRAsghar J. Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct. Neurosurg Focus. 2008;25(2):E15."},{"issue":"5","key":"bib17","series-title":"Asian Spine J","first-page":"832","article-title":"Minimally-invasive versus conventional repair of spondylolysis in athletes: a review of outcomes and return to play","volume":"11","author":"Kolcun","year":"2017","unstructured":"Kolcun JPGChieng LOMadhavan KWang MY. Minimally-invasive versus conventional repair of spondylolysis in athletes: a review of outcomes and return to play. Asian Spine J. 2017;11(5):832-842."},{"issue":"suppl","key":"bib18","series-title":"Spine (Phila Pa 1976)","first-page":"B6","article-title":"Direct repair of lumbar pars interarticularis defects by utilizing intraoperative O-arm-based navigation and microendoscopic techniques","volume":"41","author":"Jia","year":"2016","unstructured":"Jia MWang JZhang ZZheng WZhou Y. Direct repair of lumbar pars interarticularis defects by utilizing intraoperative O-arm-based navigation and microendoscopic techniques. Spine (Phila Pa 1976). 2016;41(suppl 19):B6-B13."},{"issue":"1","key":"bib19","series-title":"Neurosurg Rev","first-page":"20","article-title":"Basis for error in stereotactic and computer-assisted surgery in neurosurgical applications: literature review","volume":"46","author":"Pivazyan","year":"2022","unstructured":"Pivazyan GSandhu FABeaufort ARCunningham BW. Basis for error in stereotactic and computer-assisted surgery in neurosurgical applications: literature review. Neurosurg Rev. 2022;46(1):20."},{"issue":"7","key":"bib20","series-title":"Glob Spine J","first-page":"814","article-title":"Assessment of surgical procedural time, pedicle screw accuracy, and clinician radiation exposure of a novel robotic navigation system compared with conventional open and percutaneous freehand techniques: a cadaveric investigation","volume":"10","author":"Vaccaro","year":"2020","unstructured":"Vaccaro ARHarris JAHussain MM, et al. Assessment of surgical procedural time, pedicle screw accuracy, and clinician radiation exposure of a novel robotic navigation system compared with conventional open and percutaneous freehand techniques: a cadaveric investigation. Glob Spine J. 2020;10(7):814-825."},{"key":"bib21","series-title":"Robot Surg","first-page":"9","article-title":"Robotic-assisted spine surgery: history, efficacy, cost, and future trends","volume":"6","author":"D\u2019Souza","year":"2019","unstructured":"D\u2019Souza MGendreau JFeng AKim LHHo ALVeeravagu A. Robotic-assisted spine surgery: history, efficacy, cost, and future trends. 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