What is Neuronavigation?

Neuronavigation employs advanced technology akin to GPS, providing surgeons with the ability to visualize a patient’s anatomy in three dimensions and accurately locate positions in the brain or spinal cord. This technique utilizes diagnostic images from computer tomography (CT) and magnetic resonance (MR), sometimes combined with intraoperative images such as X-rays, allowing surgeons to monitor the procedure and instruments in real time.

Neuronavigation, also known as image-guided surgery (IGS), computer-assisted surgery (CAS), and stereotactic navigation, enhances the precision and safety of the surgery by offering real-time feedback and 3D images of the patient’s anatomy, enabling smaller incisions and minimizing exposure and trauma to healthy tissue.

How Does It Work?

Consider neuronavigation as a surgical GPS. It allows the continuous calculation of instrument positions within the body, with the data transferred to a computer in the operating room via infrared cameras. The computer superimposes the real-time positioning of the instruments onto the anatomical images displayed on a monitor, allowing the surgeon to navigate through the anatomy with unparalleled accuracy.

Why Use Neuronavigation?

Employing neuronavigation allows surgeons to know their exact working location within the body at all times during surgery, leading to minimization of trauma by avoiding healthy tissues. It enables prior planning of surgical exposure, precise placement of instruments, and increased confidence during surgery, resulting in better long-term results and potentially reduced chances of repeat surgeries.

Impact on Recovery

The precision of neuronavigation minimizes trauma, pain, and scarring, allowing for potentially better long-term outcomes and a decreased likelihood of additional surgeries. This technique offers a more tailored approach to structures in the brain, enabling minimal disruption to surrounding tissue and ensuring the complete removal of tumors without damaging nearby healthy tissue.

Neuronavigation Steps

Pre-Surgery: A diagnostic image is taken and loaded into a computer to create a 3D model of the patient’s anatomy.
Beginning of Surgery: The surgeon maps the patient’s anatomy using special techniques, linking the pre-operative diagnostic image to the patient’s anatomy with the help of an infrared camera.
During Surgery: Surgeons use the neuronavigation system to see their instruments on the computer image and confirm their exact location in real time.

Benefits in Brain Surgery

Neuronavigation is crucial in brain surgery for allowing surgeons to ‘see’ through the scalp, skull, and brain to plan trajectories, ensuring the full removal of the tumor and avoiding damage to healthy tissue. It enables precise placement of stimulators and other instruments to treat neurological disorders like Parkinson’s disease with utmost confidence.

Benefits in Spine Surgery

Given the proximity of spine surgery to the spinal cord and nerves, absolute precision is paramount. Neuronavigation aids surgeons in navigating through the bone while preventing damage to adjacent neural structures. It enables visualization and planning of exact incision and screw placement, providing a higher degree of accuracy and confidence in performing minimally invasive procedures.

Global Adoption of Neuronavigation

The use of neuronavigation is expanding globally, becoming a pivotal tool for neurosurgeons and spine surgeons in performing safer and more effective surgeries. This method has been progressively integrated into various surgical procedures since its initial trials in 1996, and has been particularly instrumental in spine surgery, aiding in spinal fusion and minimally invasive spine fixation for thoracolumbar burst fractures.

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