{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T01:00:58Z","timestamp":1784682058913,"version":"3.55.0"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"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 Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,7,20]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Pelvic fixation failure (PFF) remains prevalent in adult spinal deformity correction, with failure rates up to 35%. Current revision surgeries are highly invasive and morbid, requiring extensive incisions and recovery times. Sacroiliac joint fusions (SIJFs) may offer a salvage option for PFF. Robotic navigation has previously been explored as a feasible method for primary SIJF. In this study, the authors aim to establish the viability of robot-navigated SIJF as a salvage surgery for PFF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>This study examined that data of patients who underwent previous deformity correction of at least four levels, experienced symptomatic PFF with radiographic evidence, and underwent robot-navigated SIJF as salvage. Eight patients were identified. The mean operative time was 45.1 \u00b1 6.4 minutes and the mean blood loss was 7.5 \u00b1 3.8 mL. The mean postoperative self-reported pain improvement was 48.1% \u00b1 41.6% at 1.5 months (p = 0.029), 53.6% \u00b1 41.3% at 3 months (p = 0.007), and 58.6% \u00b1 40.4% at latest follow-up (p = 0.002). All patients with multiple follow-ups reported at least 50% improvement during the postoperative course. No complications or 30- or 90-day readmissions occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Robot-navigated SIJF for PFF consistently yielded significant pain reduction with a minimally invasive perioperative metric profile, indicating viability as a salvage.<\/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\/CASE26148\">https:\/\/thejns.org\/doi\/10.3171\/CASE26148<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26148","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:01:19Z","timestamp":1784678479000},"source":"Crossref","is-referenced-by-count":0,"title":["Robot-navigated sacroiliac joint fusion as salvage surgery for pelvic fixation failure in adult spinal deformity surgery: patient series"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1538-8944","authenticated-orcid":true,"given":"Arnav","family":"Sharma","sequence":"first","affiliation":[{"name":"Duke University School of Medicine, Durham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7151-2861","authenticated-orcid":true,"given":"Muhammad M.","family":"Abd-El-Barr","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-4070","authenticated-orcid":true,"given":"Peter","family":"Passias","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Rocos","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parastou Fatemi","family":"Quist","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Richardson","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khoi D.","family":"Than","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"Eur Spine J","first-page":"1085","article-title":"Sacropelvic fixation in adult spinal deformity (ASD); a very high rate of mechanical failure","volume":"24","author":"Guler","year":"2015","unstructured":"Guler UOCetin EYaman OSacropelvic fixation in adult spinal deformity (ASD); a very high rate of mechanical failure. Eur Spine J. 2015;24(5):1085-1091. doi:10.1007\/s00586-014-3615-1"},{"issue":"18","key":"bib2","series-title":"Spine (Phila Pa 1976)","first-page":"1976","article-title":"Minimum 2-year analysis of sacropelvic fixation and L5\u2013S1 fusion using S1 and iliac screws","volume":"26","author":"Kuklo","year":"2001","unstructured":"Kuklo TRBridwell KHLewis SJMinimum 2-year analysis of sacropelvic fixation and L5\u2013S1 fusion using S1 and iliac screws. Spine (Phila Pa 1976). 2001;26(18):1976-1983. doi:10.1097\/00007632-200109150-00007"},{"issue":"17","key":"bib3","series-title":"Spine (Phila Pa 1976)","first-page":"E945","article-title":"The comparison of spinopelvic parameters, complications, and clinical outcomes after spinal fusion to S1 with or without additional sacropelvic fixation for adult spinal deformity: a systematic review and meta-analysis","volume":"46","author":"Han","year":"2021","unstructured":"Han BYin PHai YCheng YGuan LLiu Y.The comparison of spinopelvic parameters, complications, and clinical outcomes after spinal fusion to S1 with or without additional sacropelvic fixation for adult spinal deformity: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2021;46(17):E945-E953. doi:10.1097\/BRS.0000000000004003"},{"issue":"4","key":"bib4","series-title":"J Neurosurg Spine","first-page":"445","article-title":"Failure of lumbopelvic fixation after long construct fusions in patients with adult spinal deformity: clinical and radiographic risk factors: clinical article","volume":"19","author":"Cho","year":"2013","unstructured":"Cho WMason JRSmith JSFailure of lumbopelvic fixation after long construct fusions in patients with adult spinal deformity: clinical and radiographic risk factors: clinical article. J Neurosurg Spine. 2013;19(4):445-453. doi:10.3171\/2013.6.SPINE121129"},{"issue":"1","key":"bib5","series-title":"Oper Neurosurg","first-page":"1","article-title":"Sacroiliac joint fusion using robotic navigation: technical note and case series","volume":"23","author":"Wang","year":"2022","unstructured":"Wang TYBergin SMMurphy KRSacroiliac joint fusion using robotic navigation: technical note and case series. Oper Neurosurg. 2022;23(1):1-7. doi:10.1227\/ons.0000000000000179"},{"key":"bib6","series-title":"Int J Spine Surg","first-page":"28","article-title":"Two-year outcomes from a randomized controlled trial of Minimally Invasive sacroiliac joint fusion vs. non-surgical management for sacroiliac joint dysfunction","volume":"10","author":"Polly","year":"2016","unstructured":"Polly DWSwofford JWhang PGTwo-year outcomes from a randomized controlled trial of Minimally Invasive sacroiliac joint fusion vs. non-surgical management for sacroiliac joint dysfunction. Int J Spine Surg. 2016;10:28. doi:10.14444\/3028"},{"issue":"6","key":"bib7","series-title":"Pain Physician","first-page":"537","article-title":"1-year results of a randomized controlled trial of conservative management vs. minimally invasive surgical treatment for sacroiliac joint pain","volume":"20","author":"Dengler","year":"2017","unstructured":"Dengler JDKools DPflugmacher R1-year results of a randomized controlled trial of conservative management vs. minimally invasive surgical treatment for sacroiliac joint pain. Pain Physician. 2017;20(6):537-550."},{"issue":"3 suppl","key":"bib8","series-title":"Global Spine J","first-page":"123S","article-title":"Pelvic fixation in adult spinal deformity: complications, controversies, and future directions","volume":"15","author":"Jones","year":"2025","unstructured":"Jones KEHolton KJLadd BPelvic fixation in adult spinal deformity: complications, controversies, and future directions. Global Spine J. 2025;15(3 suppl):123S-134S. doi:10.1177\/21925682241242454"},{"issue":"2","key":"bib9","series-title":"J Neurosurg Spine","first-page":"208","article-title":"Incidence, mechanism, and protective strategies for 2-year pelvic fixation failure after adult spinal deformity surgery with a minimum six-level fusion","volume":"38","author":"Lee","year":"2023","unstructured":"Lee NJMarciano GPuvanesarajah VIncidence, mechanism, and protective strategies for 2-year pelvic fixation failure after adult spinal deformity surgery with a minimum six-level fusion. J Neurosurg Spine. 2023;38(2):208-216. doi:10.3171\/2022.8.SPINE22755"},{"issue":"14","key":"bib10","series-title":"Spine (Phila Pa 1976)","first-page":"986","article-title":"Rates of loosening, failure, and revision of iliac fixation in adult deformity surgery","volume":"47","author":"Eastlack","year":"2022","unstructured":"Eastlack RKSoroceanu AMundis GMRates of loosening, failure, and revision of iliac fixation in adult deformity surgery. 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