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Image guided procedures based upon CT data have been introduced in spine surgery since 1994.

In pelvic and acetabular surgery only passive navigation systems are in use and will be described within this article. Image guided techniques can be divided into active (robotics), semi-active and passive systems (navigation). parts of the sacrum is possible as well as preservation of nerve roots. With exact resection in situ however the preservation of osseous structures, e.g. As the drilling can only be controlled in one projection at a time, it is frequently necessary to reposition the fluoroscope several times for the additional projections.16, 17, 18, 19, 22, 23įor muscolosceletal tumour resection it is rather difficult to define the exact resection line, because normal and cancerous bone can hardly be differentiated in most cases. For procedures under fluoroscopic control reasonable fluoroscopy times may be required. The most frequent percucutaneous application is transiliosacral screw fixation.

Percutaneous screw fixation in the pelvis is technically very demanding because of the pelvic geometry and is mainly performed with fluoroscopic control. Nevertheless the operative goals remain the same in terms of anatomic reconstruction of the acetabulum and near anatomic reconstruction of the posterior pelvic ring. In pelvic and acetabular surgery, a reduction in size of the operative approaches is desirable.

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