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Isaac Newton is famous for the line “If I have seen further, it is by standing on the shoulders of giants.” This is true in all aspects of life, including medicine. In healthcare we’re constantly working to improve outcomes. Sometimes this comes as a result of better understanding a disorder, added experience with medications and procedures or through advancement in technology.
Historically, spine surgery has utilized intraoperative x-ray technology (fluoroscopy) to view the spine and evaluate the placement of implants. This is still used today and is a reliable technology. With fluoroscopy a mobile unit known as a C-arm gives a two dimensional image of the spine and can be manipulated to evaluate alignment from various angles. Typically imaging is performed in the frontal and lateral planes.
Today we have access to equipment that allows spine surgeons to use three dimensional imaging during surgical procedures. This technology is known as navigation and it is advancing the practice of spinal care and improving surgical procedures and patient outcomes.
The equipment used includes an imaging system to provide an intraoperative CT scan (O-arm, Medtronic, USA) that allows for three dimensional imaging. The imaging is then transferred to a specialized computer system (Stealth station, Medtronic, USA) that provides visual feedback in real time with respect to where the surgical equipment is relative to the spinal segment being treated.
Spinal navigation allows for more accurate placement of implants, increased safety to the patient and improved outcomes. Surgical incisions are made smaller, there is less surgical trauma and the infection rates are improved due to less time in the operating room and less tissue exposure.
We all know that we could travel cross country with a Rand McNally map, but GPS systems make the travel more accurate and smoother. In a similar fashion, modern surgical equipment with imaging and computer aided navigation are making spine surgery safer and better for patients with proven results.