European Spine Journal

, Volume 22, Issue 3, pp 642–647 | Cite as

Computer-assisted fluoroscopic navigation of percutaneous spinal interventions

  • Jörg A. K. Ohnsorge
  • Khaled H. Salem
  • Andreas Ladenburger
  • Uwe M. Maus
  • Markus Weißkopf
Original Article



Percutaneous spine procedures may occasionally be difficult and subject to complications. Navigation using a dynamic reference base (DRB) may ease the procedure. Yet, besides other shortcomings, its fixation demands additional incisions and thereby defies the percutaneous character of the procedure.


A new concept of atraumatic referencing was invented including a special epiDRB. The accuracy of navigated needle placement in soft tissue and bone was experimentally scrutinised. Axial and pin-point deviations from the planned trajectory were investigated with a CT-based 3D computer system. Clinical evaluation in a series of ten patients was also done.


The new epiDRB proved convenient and reliable. Its fixation to the skin with adhesive foil provided a stable reference for navigation that improves the workflow of percutaneous interventions, reduces radiation exposure and helps avoid complications.


Percutaneous spine interventions can be safely and accurately navigated using epiDRB with minimal trauma or radiation exposure and without additional skin incisions.


Spine navigation Computer assisted surgery DRB epiDRB 



The study was conducted within a joint research project funded by the German Ministry of Education and Research (BMBF: Bundesministerium für Bildung und Forschung).

Conflict of interest



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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Jörg A. K. Ohnsorge
    • 1
    • 2
  • Khaled H. Salem
    • 3
    • 4
  • Andreas Ladenburger
    • 1
  • Uwe M. Maus
    • 2
  • Markus Weißkopf
    • 5
  1. 1.Helmholtz-Institute of Biomedical TechnologiesRWTH Aachen UniversityAachenGermany
  2. 2.Department of Orthopaedic SurgerySt. Antonius Hospital EmstekEmstekGermany
  3. 3.Department of Orthopaedic SurgeryRWTH Aachen UniversityAachenGermany
  4. 4.Department of Orthopaedic Surgery, Faculty of MedicineCairo UniversityCairoEgypt
  5. 5.Department of Spine SurgeryWertingen General HospitalWertingenGermany

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