Robot-navigated sacroiliac joint fusion as salvage surgery for pelvic fixation failure in adult spinal deformity surgery: patient series.

backgroundPelvic 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. OBSERVATIONS: 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 ± 6.4 minutes and the mean blood loss was 7.5 ± 3.8 mL. The mean postoperative self-reported pain improvement was 48.1% ± 41.6% at 1.5 months (p = 0.029), 53.6% ± 41.3% at 3 months (p = 0.007), and 58.6% ± 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. LESSONS: Robot-navigated SIJF for PFF consistently yielded significant pain reduction with a minimally invasive perioperative metric profile, indicating viability as a salvage. https://thejns.org/doi/10.3171/CASE26148.