Computer-assisted spine surgery: A technique for accurate transpedicular screw fixation using CT data and a 3-D optical localizer

The computer-assisted spine surgery system presented in this paper follows the basic ideas which have been developed for computer-assisted medical interventions (CAMI) in our lab since 1985. There are three steps to insert a linear tool inside vertebral pedicles. First, the surgeon defines an optimal trajectory on pre-operative computed tomography. Second, this trajectory is reported in the operating room coordinate system using an intra-operative sensor and a registration algorithm. Third, a guiding system helps the surgeon follow the selected trajectory. In this paper, we present an implementation of this method that uses only a 3-dimensional optical localizer. Results on cadaver specimens and on the first seven patients are presented. J Image Guid Surg 1:65-73 (1995). © 1995 Wiley-Liss, Inc.