Image-guided surgery (IGS) captures images of the spine or other surgical sites and then relies on computer algorithms to enhance those images such that three-dimensional models can be created. Virtual images of surgical instruments can be added to the images to help “visualize” surgery. IGS has been an important advancement in the planning of spinal surgery in that surgeons can use virtual tools to simulate surgery and see the results before the patient is on the table. IGS is also used during surgery so that surgeons can better visualize the spine and related anatomical structures as they operate.
IGS has resulted in faster, safer spinal surgeries and sometimes permits surgeons of today to perform operations that were impossible in the past.
What’s Involved – How it Works
IGS technology can be extremely complex, but generally involves a high-performance computer with special software algorithms, a large high-resolution monitor, specialized cameras and instruments.
Days before surgery, CT scans and/or MRI images of the patient’s anatomy are loaded into the computer. The computer uses these two-dimensional images tp create three-dimensional (3D) images. The 3D images can be rotated, enlarged (zoom feature), or manipulated in different ways allowing the surgeon to visualize the spine in a way never before possible. These 3D images are often used in planning the surgery. For example, a surgeon may rely on these images to select the type and size of instrumentation needed or plot the trajectory of pedicle screws.
The specialized instruments, cameras, and other IGS equipment can communicate with each other in real time. This means that during surgery, the surgeon can use these 3D images to help guide the course of the procedure. The surgeon observes these images on monitors in the operating room. IGS surgery may, for instance, allow a surgeon to see anatomical areas on the monitor that are not visible to his or her direct view.
Advantages
IGS offers many potential benefits to spinal surgeons and their patients. Among them are the following.
- It enhances the ability to navigate complex spinal anatomy in real time.
- It provides accurate measurements, such as screw diameter and length.
- It allows more precise implantation of spinal instrumentation.
- It can pinpoint exactly where the tip of a surgeon’s instrument is in relation to a patient’s anatomy, providing invaluable information in case unexpected or unusual anatomy is encountered.
- It reduces operating time.
- It minimizes (and in some cases, eliminates) radiation exposure previously experienced with traditional x-rays.
Conclusion
While IGS technology is remarkably sophisticated, it has a very simple benefit: enhanced patient safety. Using special equipment, 3D images of the patient’s spine and other anatomical features can be created and manipulated, both before surgery and in real-time during surgery.