Image-Based Spinal Navigation: Current Technology and Future Applications

There are many innovations in spinal navigation which have widely expanded the options spine surgeons have for safely inserting pedicle screws. Surgeons may choose to use spinal navigation systems that utilize preoperative CT imaging in order to decrease intraoperative radiation exposure to the surgical team. For cases where the spine position may shift significantly or where the anatomy is not amenable to relying on preoperative imaging, spinal navigation using intraoperative CT guidance is available. These intraoperative modalities include fan-beam CT navigation systems and cone-beam CT navigation which is also referred to as 3D fluoroscopy. The future of spinal navigation will likely include incorporating augmented reality into virtual goggles, allowing surgeons to never take their eyes off the surgical field. Other future advancements will include the use of preoperative or intraoperative magnetic resonance images linked to spinal navigation systems.