Image-Guided Neurosurgery: History and Current Clinical Applications

Image-guided neuronavigation systems provide the ability to accurately visualize surgical targets during operative procedures. Previously, neurosurgeons were limited to viewing intracranial lesions on preoperative radiologic images and using anatomic landmarks to orient themselves during surgery. Neuronavigation systems allow neurosurgeons to directly relate preoperative imaging of local craniospacial anatomy to identified operative anatomy to improve surgical accuracy. In addition, these systems are used in preoperative planning to evaluate surgical risks, select the best interventional method, and decide on the optimal trajectory for a surgical procedure. Recent improvements in medical imaging over the past few decades have led to great advancements in neurosurgery. Surgeons are now able to visualize the location of a brain lesion more accurately, and new imaging modalities allow for the identification of many lesions that had been poorly defined by older imaging methods. The combination of neuronavigation with newer imaging modalities permits surgeons to perform a more complete removal of brain and spinal cord pathologies and helps to avoid damage to important local anatomic structures, resulting in decreased patient morbidity and mortality. This review outlines the history of neuronavigation and discusses new imaging modalities that are being incorporated into current navigation systems used in operating rooms today.