We have begun to utilize image guidance to greater frequencies in the operating room. Before O-arm navigation guidance systems were available, many x-rays were required to be taken for a given procedure. While x-rays provide a useful function, they only allowed the surgeon to visualize structures in 2 planes (anterior-posterior and lateral).
Current navigation devices allow the neurosurgeon to be guided to the area of concern through pinpoint three-dimensional accuracy. It eliminates the need for large exposures, thereby preserving the normal anatomic structures of the spine.
How it is done:
After the patient is asleep, a guidance arm is either attached to the head-frame (cervical procedures), the spine once the incision is made, or through a small separate incision in the hip. A portable commuted tomography (CT) scanner is then brought into the operating room and a picture of the way the spine looks in that position at that moment in time is taken.
From this point the surgeon uses various probes to guide him accurately from the start of the procedure until the end…i.e. the incision size, decompression of bone and spurs, and the bone graft and screw placement. During the entire procedure the patient’s “spine roadmap” is projected on a large television screen/computer workstation. This is the future of modern spine surgery.