This study evaluates new applications using a novel navigation system with electromagnetic (EM) tracking in clinical routine.
The navigation system (iGuide CAPPA, CAS innovations, Erlangen, Germany) consists of a PC with dedicated navigation software, the AURORA tracking system (NDI, Waterloo Ontario, Canada) and needles equipped with small coils in their tips for EM navigation. After patient positioning a 3D C-arm data set of the spine region of interest is acquired. The images are reconstructed and the 3D data set is directly transferred to the navigation system. Image
loading and image to patient registration are performed automatically by the navigation system. For image acquisition a
C-arm system with DynaCT option (AXIOM Artis, Siemens Healthcare, Forchheim, Germany) was used. As new clinical applications we performed kyphoplasty for reconstruction of collapsed vertebrae. All interventions were carried out without any complication. After a single planning scan the radiologists were able to place the needle in the designated vertebra. During needle driving 2D imaging was performed just in a few cases for control reasons. The time between planning and final needle positioning was reduced in all cases compared to conventional methods. Moreover, the number of control scans could be markedly reduced. The deviation of the needle to
the planned target was less than 2 mm. The use of DynaCT images in combination with electromagnetic tracking-based navigation systems allows a precise needle positioning for kyphoplasty.