Actual aspects of image-guided surgery.

Use of surgical navigation systems is becoming an increasingly important part of both planning and performing intracranial and spinal surgery. Numerous clinical reports have described neuronavigation as a useful adjunct to surgery that allows neurosurgery to be less invasive and more effective. Although the method of image-guided surgery was introduced more than a decade ago, new technologies have changed and refined the procedure substantially. This chapter summarizes the recent developments of advanced image-guided surgery. For most operations, microscope navigation has replaced pointer navigation. Using the microscope as the localizing device, the workflow is not interrupted and microsurgical procedure can be continued as usual. New chip technology allows integration of magnetic resonance images, angiography findings, endoscopic view, or other pictures in the eyepiece of the microscope. A new method of patient registration is laser scanning and surface matching. When using high-quality images, this new method can be used without additionally acquired images, may reduce costs, simplify the pre-registration procedure, and increase application accuracy compared to skin-fiducial registration. Moreover, integration of other imaging modalities is becoming an increasingly used feature and provides useful information during surgery.