Development of spinal navigation
Spinal navigation was introduced in the early 1990s as advances in computer-based technologies enabled a transition from frame-based systems developed for cranial surgery to frameless navigation systems.
First-generation frameless systems involved a range of technologies, including two-dimensional (2D) fluoroscopy and wired navigation instruments. Second-generation systems involved passive reflective reference frames, point-by-point matching (PPM), self-registration, and relied on preoperative computed tomography (CT) datasets loaded onto an image postprocessing workstation.
Current generation systems encompass and incorporate intraoperative three-dimensional (3D) CT (and CT-like) imaging with automatic registration and computer-guided software that allow the user to visualize 3D spinal anatomy and track instrumentation in real time.