Einsatz der Navigation bei Beckenoperationen

Abstract

Spiral CT and MRT modalities with the capacity for very high resolution can be used for preoperative diagnosis of pelvic fractures; these techniques allow excellent 3D visualization. So far it has not been possible to apply these options directly during the actual surgery. Intraoperative imaging is limited by intraoperartive fluoroscopy and visualization by the approaches. Especially in surgery of the pelvis it is obvious that wider access routes lead to restricted imaging and also to morbidity. One solution offering enhanced precision and reducing radiation exposure is computer-assisted surgery (CAS) since imaging data can be imported without further imaging. CAS can be divided into CT-based navigation, which requires registration, and registration-free fluoroscopy-based or iso-C 3D navigation. We apply CAS within the pelvis during internal fixation of pelvic ring fractures with screws, for revision operations in cases of malunion after pelvic ring fracture, and in tumor surgery. At present it can be applied in only a few of the steps of such operations, and it remains to be seen whether extension of its use to the remaining steps will prove financially viable, though in view of the lower complication rate it would seem worthwhile. © Springer Medizin Verlag 2004.