FREQUENTLY ASKED QUESTIONS

What is Image-Guided Surgery?
The entire image-guided surgery process can easily be correlated or compared to location and directional tracking systems used for cars and ships today. The image-guided surgery system camera performs much like the satellite that detects signals from vehicles that are quipped with special tracking devices. As the vehicle moves the satellite calculates position, transfers the information to the vehicle computer, which in turn shows the direction the vehicle is moving and when programmed will give specific directions as to how to proceed.

How does an image-guided surgery system work?
A CT or MR scan is essential to an image-guided surgery procedure. Special markers or "fiducials" may be placed on your head prior to a cranial scan. This scan will be loaded into a computer and your surgeon can build a three-dimensional (3D) model of your head or spine to be viewed on a computer monitor. Viewing the model and scan information, surgeons can plan, in advance, their surgical path and identify the surrounding anatomy. At the start of your surgical procedure, the image-guided surgery system will be moved into the operating room. Your scan will be displayed on the computer screen and the surgeon will conduct what is referred to as a "registration" process. Registration is simply matching your physical anatomy to the computer scan information. As the registration process begins, the surgeon will touch the center of the "fiducials" or markers that were placed on your head or by touching specific anatomical points on the spine or cranium with an image-guided instrument. The camera for the image-guided surgery system will see the light emitting diodes on the instrument and on the arc and will transfer a signal to the computer to "register" the specific location being touched. By matching the scan to the real anatomy, the surgeon can now track instrumentation as it proceeds into the operative field as well as view its relative position and trajectory.

Are there different types of image-guided surgery systems?
Yes. Several companies manufacture image guided surgery systems. The systems are differentiated by software and the applications or procedures they can assist in performing.

Is an image-guided surgery system like a robot? Will my surgeon still perform the operation?
Image-guided surgery systems are not robotic in design. The surgeon still holds and guides the instruments. It is possible that robotics will be integrated with image-guided surgery systems in the future but all systems are still directly dependent upon the surgeon, performing your procedure. The image-guided surgery system provides a tool that enhances the surgeons ability to perform certain procedures.

Why might I request to have my surgeon use an image-guided surgery system for my procedure?
Patients may be interested in the use of image-guided surgery for multiple reasons. Image-guided surgery systems can increase accuracy levels in both identifying and removing tumors or lesions and in the placement of implants for spinal surgery. Image-guided surgery systems can also enable surgeons to more accurately identify surgical entry points and targets and reduce the size of incision or entry point necessary to perform an operation. These benefits often lead to shorter hospital stays and faster recovery. In certain cases, tumor biopsies can be performed with an image guided surgery system with far greater accuracy and with significantly less trauma to the patient.

Will there be any special requirements of me to have an image-guided surgery system used in my case?
There are a few special requirements for patients undergoing a procedure with an image-guided surgery system. In preparation for surgery, a special MR or CT scan will be required in order to obtain the images necessary for the procedure. This scan may require slightly more time than a typical MR or CT scan. In addition, it is possible that your surgeon will request that special "fiducials" or markers be placed on your head prior to the scan. These markers are very important because they will ultimately provide the method for the surgeon to ensure that the image guided surgery system performs, as it should. "Fiducials" or markers look like very tiny donuts and are coated with a special compound to ensure that they will show up on your scan. These markers will need to remain on your scalp up until the start of surgery and you may be required to wear overnight depending upon when your image-guided surgery scan is performed. If they fall off during the night, they should be left off so as not to mislead the surgeon. "Fiducials" or markers are not utilized in spine surgery. Following the scan and use of the fiducials in neurosurgical procedures, there will not be any additional