Background: Spinal navigation has evolved greatly since its implementation in the mid-1990s and is now widely used in lumbar spine surgery. However, navigation is not yet accepted as a standard technique.
Applications: In addition to the classic use in lumbar pedicle screw instrumentation, navigation technology, especially in combination with intraoperative 3D imaging, can be applied in a wide range of indications and in all lumbar approaches. The technology is particularly helpful in minimally invasive operations. The concept of "total navigation" stands for an efficient use of the technique from skin incision on and aims at complete elimination of radiation exposure for the surgical team.
Advantages and pitfalls: High accuracy and low radiation exposure of the OR team are indisputable advantages of navigated operations, while time savings and economic benefits are yet to be demonstrated. Regular use and standardized workflow are essential for the safe and effective application of lumbar navigation. Currently, lumbar navigation technology is already of great importance, yet the complex technology requires intensive training. With improved user comfort and image quality, spinal navigation will continue to spread in the future.
Keywords: 3D-imaging; Accuracy; Lumbar vertebrae; Pedicle screws; Surgery, computer assisted.