Exploring frameless stereotactic image guided surgery.

Frameless stereotactic image guided surgery (IGS)--a fairly new modality originally used in cranial neurosurgical procedures--has been found to have several advantages over traditional framed methods of three-dimensional navigation. Frameless stereotactic IGS is proving useful in neurosurgical procedures by allowing screws to be placed in the spine more quickly and accurately than with traditional methods. As IGS becomes standard clinical practice for certain spinal procedures--overlapping both neurosurgery and orthopedic specialties--new ideas for surgical application of the technology are developing. Currently, frameless stereotactic IGS is being investigated for use in hardware placement in orthopedic procedures and for endoscopic navigation in otorhinolaryngologic sinus procedures. Frameless stereotactic IGS is expected to gain application approval in both orthopedic and otorhinolaryngologic specialties from the US Food and Drug Administration in the near future.