Pearls and pitfalls of posterior superior iliac spine reference frame placement for spinal navigation: cadaveric series

Abstract

BACKGROUND Navigation and robotics are important tools in the spine surgeon’s armamentarium and use of these tools requires placement of a reference frame. The posterior superior iliac spine (PSIS) is a commonly used site for reference frame placement, due to its location away from the surgical corridor and its ability to provide solid fixation. Placement of a reference frame requires not only familiarity with proper technique, but also command of the relevant anatomy. OBSERVATIONS Cadaveric analysis demonstrates a significant difference in PSIS location in males versus females, and additionally provides average thickness for accurate placement. LESSONS In this technical note, the authors describe the precise technique for PSIS frame placement in addition to relevant anatomy and offer solutions to commonly encountered problems.