One of the greatest advances in spinal surgery in recent years has been computer aided navigation. This brings greater safety, time saving and ability to do more complex procedures. The basis of computer navigation is linking a three-dimensional CT scan image of the spine with the real thing in the operating theatre, so that the position of a surgical instrument can be projected onto that image, thus guiding the surgeon when putting in screws or making cuts in bone. Special sensors held above the operating field detect the position and movement of modified surgical instruments carrying optical markers. The surgeon can see a three-dimensional image on a screen by the side of the operating field.
At Prince of Wales Private Hospital we have the Brainlab system which incorporates a CT scanner with the operating table. This system is accurate because it images the patient while they are lying on the operating table. I have used it a lot for deformity surgery and difficult fusions, especially in revision cases.