Image guidance in spine surgery.

Computer image guidance is one of the most significant recent technologic advancements in the field of spine surgery, because preoperative or intraoperative images can be used for multiplanar, three-dimensional intraoperative navigation. Laboratory and clinical studies have demonstrated that image guidance increases the safety and accuracy of a variety of spinal procedures. This article describes the application of intraoperative image guidance to spinal surgery, with a particular focus on minimal access procedures. Although commonly performed separately, these techniques can work in a complementary fashion. The apparent benefits and limitations of the various image-guided modalities are described.