Image-guided navigation systems have evolved tremendously since they first became available in the 1990s. This technology, borrowed was initially difficult to use during surgery due to intraoperative shift of anatomy and of the inability to use skin and surface landmarks for registration.
Imaging systems include C-arm fluoroscopy, preoperative Computed Tomography (CT) based navigation, 2D fluoroscopy based navigation, and more recently, cone beam CT based navigation and intraoperative CT based navigation. Although the more primitive intraoperative imaging systems are relatively inexpensive and widely available, they require additional pre-operative preparation time and re-registration at each level for multiple level surgeries. Furthermore, they cannot produce axial reconstructions and expose the surgeon and operating room personnel to radiation.
Newer imaging techniques such as intraoperative CT based navigation allow for automatic registration, three-dimensional, multi-planar reconstructions, extended scan volume, and eliminate the need to obtain specialized pre-operative imaging for registration. Intraoperative image-guided spinal navigation has been shown to be a useful adjunct for spinal surgeons especially during the placement of spinal implants. This technology is particularly useful during minimally invasive spine procedures where direct visualization of the spinal anatomy is often not possible.
Further elaboration is available under Microscopic Spine surgery