A Novel Multimodal Surgical Navigation System Assisted by Ultrasound Imaging and Optical Tracking for Spine Surgery

Three-dimensional (3D) surgical navigation provides surgeons with precise intraoperative guidance, improves surgical outcomes, and reduces the risk of reoperation. Unlike traditional surgery, which relies heavily on the surgeons knowledge and experience, 3D surgical navigation brings patient medical imaging into the operating room, offering real-time anatomical information of the surgical site. However, existing surgical navigation systems typically rely on intraoperative computed tomography (CT) for image registration, which exposes patients to ionizing radiation, involves lengthy scanning times, and incurs high costs. To overcome these challenges, we developed a novel 3D multimodal surgical navigation system for spinal surgery. This system integrates ultrasound imaging for intraoperative 3D surface topography reconstruction, ultrasound-to-CT image registration, and optical tracking for real-time surgical instrument localization. As a result, the system provides intraoperative ultrasound imaging, dynamic surgical navigation based on preoperative CT images, and real-time surgical instrument tracking, delivering updated surgical navigation throughout the procedure. We evaluated the system using an agar-based spine phantom, and the experimental results demonstrate its potential to enhance the accuracy and efficacy of spinal procedures.