Spine and Cranial Navigation: The Latest Surgical Technology

In recent years, spine and cranial navigation has come into prominence as the latest technological innovation in the medical field. In particular, Image Guided Surgery (IGS) systems have recently allowed surgeons to perform radiation-free spinal and cranial navigation, efficiently and cost effectively. This type of technology is especially important in cases that high surgical accuracy is required, as is often used by neurosurgery and orthopedic surgeons. Best of all, it is considered much safer with less potential side effects than other types of surgeries.

This type of navigation is increasingly becoming utilized in operating rooms worldwide with greater frequency. In addition, various studies are taking place to determine future outlook.

What is Spine and Cranial Navigation?

Similar to a Global Positioning System (GPS), the IGS image guided system allows spine and cranial navigation to be performed simply and effectively.

  • Spinal Navigation – For example, during the spine registration process, surgeons can attach the bone clamp reference frame quickly and easily. This can often be done with just one hand in mere seconds. Next, the surgeon can identify localized points on a 3D surface and pre-operative scan. This is followed by Flash Registration. Flash Registration means that surgeons use an automated foot pedal to obtain a 3D colour image that aligns to the pre-operative CT with visible light, not radiation. Fourthly, surgeons will touch anatomical landmarks for confirmation. The entire process often takes about 20 seconds.
  • Cranial Navigation – Similarly, in cranial navigation, the machine-vision enables accurate posterior fossa registration by flashing directly into the skull. It allows surgeons to effortlessly navigate any region by flashing directly to the area of interest. Best of all, the contactless registration enables a sterile workflow.

Cranial Treatments

Some examples of cranial treatments include skull-based surgeries. During a skull-based surgery, a multi-faceted probe allows uninterrupted navigation view while using an endoscope. During frame-less biopsies, surgeons quickly and easily pre-plan their trajectory with a navigated biopsy needle that helps them visualize the real time location of the tip. In prone positioned surgeries, an advanced registration algorithm makes the registration process rapid and simple, saving surgeons precious time during the procedure. During pediatric surgeries, no electro-magnetic navigation is needed, ensuring the procedure is safe for even infants. In AVM and aneurysm surgeries, a unique multi-slice view allows surgeons to clearly visualize vessels during surgery. Finally, in shunt surgeries, navigable shunts allows surgeons to easily visualize the shunt during placement.

Spinal Treatments

Some examples of spinal treatments include surgical resection of intradural and spinal column tumours, cases of infection, revision procedures on arthrodesed spines, as well as deformity cases with distorted anatomy. Additional examples of spinal treatments include tumour removal, spinal fusion, discectomy, spinal device implantation, and spinal decompression.

Spine Registration Instruments

Some examples of spine registration instruments include a reference clamp, which allows for quick, one-handed application to the bone. Other examples include the Awl – Sharp Tip, which allows a surgeon to make a pilot hole through the cortical bone with a sharp, narrow tip with integrated measurements. It is designed to preserve line of sight down shaft of tool. Finally, the pedicle probe is used after the awl to continue the pilot hole through the softer cancellous bone. It includes integrated measurements and is designed to preserve line of sight down shaft of tool. Depth and width, displayed in millimetres, are shown to allow accurate real-time sizing of implants.

Cranial Navigation Instruments

Some examples of spinal navigation instruments include registration probes, microscope probes, biopsy probes, biopsy needles, and biopsy tracker attachments.

Improved Staff Safety

One of the benefits of these types of navigations is that they enable staff safety and reduce radiation. For example, during regular surgery, physicians can exceed their Lifetime Occupational Radiation Limit within the first decade of their career. In addition, female orthopaedic surgeons have a higher prevalence of breast cancer, while radiation technologists are at a higher risk of leukemia. Finally, spine surgeons receive significantly greater radiation levels than non-spinal procedures that involve the use of a fluoroscope.  These radiation levels are often 10-12 times greater.

Additional Benefits

Spinal and cranial navigation also have more benefits than simply staff safety. For example, cranial navigation allows for effortless registration using the patient’s own anatomy as virtual fiducials. The MvIGS system is also able to flash directly into the skull surface, eliminating the need for sponge fiducials and enabling accurate post-fossa registration. In addition, the foot pedalcontrol of the software, allows the surgeon total control. The ease of use and streamlined workflow allows surgeons to focus on the patient, as opposed to the operating room equipment. This further reducing the chances of error.

Additional benefits include superior accuracy and image quality with a pre-operative CT, improved workflow efficiencies, and cost-effective and flexible surgical options. In addition, spinal and cranial navigation provides real-time positioning of surgical tools in relation to the patient’s anatomy. This allows for superior accuracy.

Specifically, for tumour removal in spine navigation, this technology helps outline and contour the tumour, as well as important surrounding structures, such as the spinal column and nerves.

In addition, spine and cranial navigations allows surgeons to address simple, as well as complex pathologies, with better outcomes and faster recovery times.

Finally, IGS navigation allows surgeons to lessen their use of hazardous techniques, such as X-rays, which expose patients, as well as staff, to harmfulradiation.

Other Types of Navigation

In addition to spine and cranial navigation, innovations in ENT navigation have also been made in recent years. ENT navigation can help simplify a variety of procedures, including deep-seated lesions, CFS Rhinorrhearepair, distorted sinus anatomy, revision sinus surgery, extensive sino-nasal polyposis, and pituitary tumour removal. Examples of pre-calibrated navigable instruments include suctions, drills/ debriders, and endoscopes. Benefits include no lengthy cables, quick and easy setup, easy calibration, and wireless control with a smart controller.

Spinal and cranial navigation is slowly creating exciting and innovative change in the surgical field.