Navigation Systems for Spinal Surgery(<SPECIAL ISSUES>Topics of Therapy for Spine Surgery)

Abstract

This article is an overview the current status of navigation systems used in spinal surgery to emphasize their importance and to clarify the trend in which navigation technology is evolving. At this moment, there are three major latest-model navigation systems (S7 [Medtronic], Cart II [Stryker], and Kolibri [BrainLab]) used in Japan. Each system has its unique characteristics. It is essential to select the most suitable system based on the specific, differing needs of each hospital. Navigation assist is useful especially in transpedicular screw placement. The navigation unit is used for preoperative screw planning and it assures safety during its insertion. Therefore, it also offers a good spine surgery educational benefit. There are a couple of key points to safely use navigation systems. First a combination of fluoroscope and navigation is mandatory. Secondly, a reference frame should be established and remain untouched during the procedure. Recently, some new technologies have been invented to enable more precise navigation. Intraoperative acquisition of the source image is one such example. Also, robotic assist under navigation guidance for percutaneous pedicle screw placement has been introduced abroad. And in the future, a navigation technique based on the intraoperative functional image may become practical.