Occipitocervical fusion addresses instability affecting the junction between the skull and upper cervical spine, typically resulting from trauma, rheumatoid arthritis, tumours, or congenital abnormalities. This complex procedure involves connecting the occipital bone of the skull to the upper cervical vertebrae using plates, rods, and screws. The significant challenge lies in achieving secure fixation in the occipital bone while navigating the complex neurovascular anatomy of the craniovertebral junction.
The robotic approach to occipitocervical fusion begins with meticulous preoperative planning to identify optimal implant positioning based on individual anatomy. After prone positioning and registration, the robotic system creates a detailed 3D map of the craniovertebral junction. Our spine care surgeon at Manipal Hospital Old Airport Road plans precise locations for occipital screws, avoiding venous sinuses and achieving optimal bone purchase in the thicker regions of the occipital bone. The robotic arm guides placement of each occipital screw and subsequent cervical instrumentation with exceptional precision.
This accuracy is particularly valuable for the occipital screws, where traditional techniques rely heavily on anatomical landmarks that can vary significantly between patients. The precise screw placement allows for optimal rod contouring and secure connections between the occipital plate and cervical instrumentation, potentially improving construct stability while reducing the risk of implant failure in this biomechanically challenging region.
