Surgical Navigation
What is Surgical Navigation?
Surgical Navigation is an exciting new technology that is revolutionizing
spine surgery.
Imagine being able to “see” the spine without having to expose
any of the delicate tissue
surrounding it. It has many of the elements of computerized or “virtual”
surgery except it is
not virtual it is real.
Dr. Kleeman has been involved in pioneering research with this new technology
for over
10 years. He describes it as flying an airplane on instruments alone.
As an instrument
rated pilot, Dr. Kleeman is familiar with this technology. It requires
looking at multiple
instruments or screens simultaneously and using the combined information
to navigate
through unseen territory.
Here is how it works:
In order for the surgeon to “see” the spine, some standard
imaging is first taken. This can be
standard x-ray images or a more sophisticated imaging such as CAT scan.
Regular images
allow for navigation in two planes only while CT allows for 3-D imaging.
This is done in the
operating room with the patient in the position that will be used for
the surgery. A special
computer with an attached camera is used to store the images that will
later be synced
with the surgical instruments.
O-arm generating CT scan for navigation Navigation antenna
attached to pelvis
Before the image is taken, a reference frame is placed on the patient.
This frame is inserted
through a small incision the size of a pencil. It is attached to the pelvis
or some other bone
that is fixed in space relative to the spine. On the frame are several
light reflective spheres.
The surgical instruments have similar spheres on the same type of frame.
The computer screen
shows the spinal images with the surgical instruments superimposed on
the same screen. In
reality it is the spheres that the computer camera sees. By tracking the
movement of one set
of spheres in relation to the other set, the navigation is possible.
 
Nerve monitoring and navigation probe Instruments
seen on navigation screen
The accuracy is remarkable, usually within a couple of millimeters. The
computer has images of the
instruments already stored in its database allowing the ability to move
from one instrument to another.
Even the bone screws have the ability to be visualized on the screen.
This allows the surgeon to
know that the length and diameter of the selected screw will fit perfectly
with the patient’s spine.
Pedicile screws seen on navigation screen
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