Computer-assisted surgery

The term "computer-assisted surgery" (CAS) contains a variety of different applications. Priorities in trauma surgery have navigation systems. In fact, two basically different developments can be distinguished: on one hand, the possibility of navigation, based on preoperative CT data sets; and on the other hand navigation in intraoperative C-arm images. With the present available navigation technology, it can be assumed that intra-operative CT-based tracking in the field of spinal surgery can be performed accurately, regardless of whether active or passive markers are used. Another navigation option is C-arm-based osteosynthesis of the proximal femur. An application of navigation assistance in the field of pelvic surgery is osteotomy and placement of iliosacral screws. Future developments will have to concentrate on the technical characteristics of each navigation system. Advantageous concepts of visualization may generate required information to the surgeon in a way that unconstrained interaction at the operation table is combined with simultaneous integration of virtual and computer-aided visual information. New tracking systems will allow the reconstruction of data sets after reposition of segmented bone fragments, so that also in complex pelvic fractures the implantation of screws after reposition will be possible. Computer-aided surgery is able to improve the precision of operations in trauma surgery. In future, further developments of navigation systems can be expected. This fact is supported by the establishment of faster and cheaper hardware, as well as more intelligent and user-friendly software.