3-D Stereotactic Surgical Image Guidance for Both Cranial and Spine Surgery 

This procedure, called stereotaxy, uses advanced computers to locate and create a three-dimensional image of a tumor or bone anatomy. When used during surgery, the technique is called stereotactic surgery. Whereas conventional x-rays measure only two dimensions – height and width, stereotaxy adds the third dimension of depth, which enhances the neurosurgeon’s ability to map the tumor location and determine the safest way to remove it. Stereotaxy also allows the surgeon to plan trajectory, or angle of approach, to make placement of surgical implants such as spinal pedicle screws as accurate as possible. 

Stereotactic techniques may be used to prepare for a surgery, during biopsy or tumor removal, to remove blood clots from the brain, to more accurately place drains or shunts for hydrocephalus, or to provide a navigation system during surgery. These techniques are useful in locating and removing tumors deep within the brain, such as brain stem and thalamic tumors. Stereotactic systems are used in operating rooms, enabling physicians to plan the safest, most direct route to a lesion and make the smallest incision possible before ever starting the surgery, and to view images of the brain as surgery is performed. 

Special instruments are tracked either by cameras or radio waves that precisely locate the position of the instrument in relation to the patient’s anatomy. This allows the surgeon to both locate anatomical and pathological features before they can be seen, and to more accurately estimate how much pathology has been removed in the case of tumor removal. 

Use of 3-D stereotactic procedures represents the future of spinal surgery navigation. With the procedures, x-ray equipment can automatically rotate around the patient while maintaining the spinal anatomy at its center. The result is quicker high-quality multi-plane images that compare to CT scanners. The advantages of this technology include less exposure to x-rays for both the patient and surgical team, more accurate placement of spinal instrumentation than is possible using conventional x-ray techniques, and potentially less invasive surgical procedures, depending on the type of surgery and instrumentation being placed.