Trackerless Surgical Guidance Software for Spinal Screw Placement

Siemens Healthineers has integrated the trackerless Vuze guidance software into its Cios Spin mobile C-arm system to assist surgeons during spinal operations. This software-based approach supports precise K-wire placement for pedicle screws across spinal fusion, vertebroplasty, and kyphoplasty procedures.

Challenges in Spinal Navigation and Fixation
Spinal surgery requires exact instrumentation to avoid critical anatomical structures. Conventional navigation systems necessitate external tracking hardware, such as optical cameras, physical reference frames attached to the patient, or instrument markers. These configurations often disrupt the surgical workflow, require continuous line-of-sight maintenance, and increase the equipment footprint within the operating room.

Image Fusion Mechanics for Trackerless Guidance
The Vuze guidance software eliminates the reliance on external tracking devices. The system fuses preoperative Computed Tomography (CT) or intraoperative cone-beam CT (CBCT) scans directly with intraoperative 2D X-ray images. This image overlay provides precise anatomical mapping, guiding the placement of K-wires for pedicle screws from the T7 to L5 vertebrae while the patient remains in a prone position. During experimental evaluations on artificial spine models, this markerless 2D/3D image guidance achieved a screw placement accuracy of up to 96.7 percent.

Mobile C-Arm Integration and System Architecture
Holding FDA 510(k) clearance for specific spinal fixations, the software is engineered to integrate seamlessly into the workflow of the Cios Spin mobile C-arm system. Siemens Healthineers plans to expand this integration across its broader portfolio of 2D mobile, 3D mobile, and 3D robotic C-arms. This software-centric approach allows medical facilities to upgrade existing imaging workflows without installing dedicated optical tracking infrastructure.




Additional Context
This section details technical specifications and competitive benchmarking not included in the original product announcement

Within the spinal navigation market, standard solutions such as the Medtronic StealthStation and the Brainlab Kick platform rely heavily on optical tracking arrays and stereoscopic cameras to monitor surgical instruments in real-time. While these established platforms offer high sub-millimeter precision, they require specialized surgical tools and an unobstructed line-of-sight, which can be easily blocked by surgical staff. By integrating Vuze directly into the C-arm ecosystem, Siemens Healthineers transitions the methodology from hardware-centric spatial tracking to software-based image fusion. This alignment with markerless navigation utilizes inherent radiographic landmarks rather than external fiducial markers to maintain registration accuracy during posterior pedicle screw fixation.

Edited by Maria Brueva, Induportals editor – adapted by AI.

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