Effect of Instrument Navigation on C-arm Radiation and Time during Spinal Procedures: A Clinical Evaluation

Anterior-posterior visualization of L3-L5 vertebra and sacrum as displayed within the instrument navigation software. (A) X-ray image taken with instrumentation intentionally placed in incorrect location (to demonstrate concept) with approximated instrument tip location (within the circle) and trajectory (direction of the arrows). (B) A subsequent fluoroscopic image demonstrates actual initial instrument placement, which is too lateral to the desired location. (C) Instrument tracking is activated, and thus the instrument can then be traced in virtual live fluoroscopy to the desired location without the use of additional fluoroscopic images. Note the image of the instrument is moving over the anatomy. The moving tip locates the new tip position, and the arrows indicate changed trajectory. (D) Final fluoroscopic image confirms the instrument positioning (3 total fluoroscopic images).