Frameless spinal stereotaxis

Frameless spinal stereotaxis, also termed 'image-guided spine surgery', is a recently developed technique that improves intraoperative spinal localization and navigation. This technology allows for precise mapping of surgical anatomy to preoperatively acquired computerized tomographic images in a real-time fashion. The ability to manipulate three-dimensional radiographic anatomy in clinically relevant planes and directly relate these images to surgically exposed structures provides the surgeon with an unprecedented ability to preoperatively plan surgical trajectories and localize spinal structures intraoperatively. Surgical tools can be tracked in relation to these anatomic displays, providing a view of 'hidden' structures beneath the exposed spinal surface and a 'look-ahead' view of proposed drill or screw trajectories. The resultant improvements in accuracy have been demonstrated experimentally and clinically. The technology has proven to be most useful in situations of unusual or complex anatomy. The investigative and clinical applications of frameless spinal stereotaxis continue to grow at a rapid pace. Future uses will extend to other structures, such as the pelvis and appendicular skeleton.