Wallace Nicholas, Schaffer Nathaniel E, Freedman Brett A, Nassr Ahmad, Currier Bradford L, Patel Rakesh, Aleem Ilyas S
Department of Orthopedic Surgery, Division of Spine Surgery, University of Michigan, Ann Arbor, MI, USA.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
J Spine Surg. 2020 Mar;6(1):136-144. doi: 10.21037/jss.2019.11.13.
Stereotactic navigation is quickly establishing itself as the gold standard for accurate placement of spinal instrumentation and providing real-time anatomic referencing. There have been substantial improvements in computer-aided navigation over the last decade producing improved accuracy with intraoperative scanning while shortening registration time. The newest iterations of modeling software create robust maps of the anatomy while tracking software localizes instruments in multiple display modes. As a result, stereotactic navigation has become an effective adjunct to spine surgery, particularly improving instrumentation accuracy in the setting of atypical anatomy. This article provides an overview of stereotactic navigation applied to complex cervical spine surgery, details the means for registration and direct referencing, and shares our preferred methods to implement this promising technology.
立体定向导航正迅速确立其作为脊柱内固定精确放置和提供实时解剖参考的金标准地位。在过去十年中，计算机辅助导航有了显著改进，通过术中扫描提高了准确性，同时缩短了注册时间。最新版本的建模软件可创建强大的解剖图谱，而跟踪软件能在多种显示模式下对器械进行定位。因此，立体定向导航已成为脊柱手术的有效辅助手段，尤其在非典型解剖结构情况下提高了内固定的准确性。本文概述了应用于复杂颈椎手术的立体定向导航，详细介绍了注册和直接参考的方法，并分享了我们实施这项有前景技术的首选方法。
