Over the years, technological advancements, such as bio-resorbable, flexible and radiolucent spinal implants, genetic engineering of disc tissue, bone fusion, or vertebral bone, as well as image guided surgery systems have made the spine surgery process safer and less invasive.

In particular, spinal navigation surgery technology or Image Guided Surgery (IGS) allows surgeons to—easily and effectively—perform safer, less invasive, cost-effective, and radiation-free spinal navigation. Navigation surgery has come into medical practice in the past 20 years. It allows surgeons to answer questions, such as “Where is my (anatomical) target?” and “How do I reach my target safely?” In addition, it can also answer questions such as, “Where am I (anatomically)?”and “Where and how should I position my implant?”

Spinal navigation, or minimally invasive spine surgery (MIS), allows surgeons to visualize the anatomy of their patient’s spine during the surgery. In addition, this surgery technology also allows surgeons to track the exact movements of their surgical instruments while working on the spine.

In addition, recent innovations in technology now allow surgeons to reduce patient registration to less than 20 seconds, as opposed to the traditional 30 minutes.

What Does Spinal Navigation Surgery Technology Entail?

Spinal navigation surgery technology entails taking an X-ray to confirm the location of the spine itself, or of various spinal implants, such as rods, hooks, screws, or plates.

Spinal Navigation Surgery Procedures

Spinal navigation can be used for a variety of surgeries, including those involving the thoracic spine, the lumbar spine, as well as the pelvis.

  • Thoracic Spine – Spinal navigation is perfect for the smaller structures of the upper spine, with its precision and ability to navigate difficult structures.
  • Lumbar Spine – Similarly, spinal navigation for the lumbar, or lower spine, allows surgeons to improve their efficiency.
  • Pelvic Trauma – For pelvic trauma, spinal navigation surgery technology helps simplify complex pelvic procedures, with precision and increased ease in navigating difficult structures.

Spinal Navigation Patient Registration Process

  • The patient registration process for spinal navigation can be divided into 5 main categories.
  • Firstly, the reference frame, in which the bone clamp reference frame is quickly attached with only one hand, is placed.
  • Secondly, 3D surfaces must be identified, as well as and pre-operative scan definition points.
  • Thirdly, Flash registration occurs with a convenient foot pedal, allowing 3D color image to instantly align to the pre-operative CT.
  • Next, anatomical landmarks are verified.
  • Lastly, image navigated surgery can finally begin.
  • Spine registration instruments include reference bone clamps, awl-sharp tips for making pilot holes to cortical bones, as well as pedicle probes to continue the pilot holes to softer cancellous bones.

Benefits of Spinal Navigation

Unlike in the past, when surgeons were forced to rely on an X-ray to guide them through the spine’s anatomy, spinal navigation has now allows surgeons to know where their instrument is at all times.

Accuracy has been seen in various studies, including one that revealed that the accuracy rate of navigation systems placing pedicle screws was 90.76%, in comparison to traditional fluoroscopic guided screws, which were only accurate 85.48% of the time.

Spinal navigation takes place in real-time, right in the operating room, with data obtained intraoperatively. The surgeon is now able to more accurately place their instruments, allowing for safer and more effective spinal decompression and removing tumours. However, spinal surgeries can also be planned on a computer beforehand.

In addition, greater accuracy results in less collateral tissue damage, reduced muscle damage, as well as reduced blood loss and post-operative pain.

Reducing intra-operative radiation for surgeons, radiation technicians, staff, and patients has a great deal of health benefits. This is especially important, as there has been increased instances of breast cancer amongst female orthopedic surgeons.

For patients, these advances mean increased relief from pain and neurological problems.

The Future of Spinal Navigation Surgery Technology

The future of spinal navigation surgery technology is bright. Instead of having to send patients for a preoperative MRI or CT scan, surgeons will be able to obtain computer images and models of the spine right in their operating rooms. As the surgeon can navigate the spine carefully, it will be much easier to see detail that can often be missed by the human eye in traditional surgeries.

Some examples of future bio metals that will be used for spinal surgery are titanium, an excellent choice for cages, rods, screws, hooks, wires, plates, and bolts. Titanium also works well with CTs and MRIs, as traditionally used stainless steel can cause blurred images. In addition, innovations involving bone grafts, from the patient’s own body or bone bank, as well as genetically engineered proteins, such as Bone Morphogenetic Proteins (BMP) for bone fusion surgery are being advanced as well.

Spinal surgery is now safer and more-cost effective for both patients and surgeons with innovations in spinal navigation surgery technology.