Spine Navigation System

for electromagnetic instrument tracking in spine surgery

Live instrument display without X-Ray exposure

The navigation system displays the position and orientation of all tracked instruments relative to the patient anatomy in real-time. Only two X-Rays are taken at the start of the procedure. They are registered to the patient with a simple registration tool, which can be removed after the registration process. During surgery the view provided by the navigation system is similar to a „live“ X-Ray, but without continuous exposure to X-Ray radiation and with the additional advantage that both anterior-posterior and lateral views are updated simultaneously.

Operational concept with intention recognition

Thanks to a sophisticated user guidance system, the required number of necessary interaction steps is minimal. The system anticipates the interaction the surgeon intends, based on the workflow in Spine surgery, and actively facilitates the operation. No further user input is required during the course of the procedure. The system’s simplicity in control is thereby un- paralleled. Preparation time is reduced to a minimum, and there is no need for a disruptive foot pedal.

Minimal footprint in the operating room

The navigation system can easily be integrated into any equipment trolley and endoscopy tower. This makes setup fast and simple and ensures there is enough space for ideal access to the surgical site.

Integration into clinic network

The navigation system offers a comprehensive range of options for integration into a clinic network and into a networked operating room, like video inputs and outputs and PACS accessibility.

Sensor at the tip for high accuracy

The instrument’s position is measured at its tip, meaning that accuracy is greatest at exactly the point where it is needed most. Measurements at the tip will be highly accurate even if the remainder of the instrument is deformed.

No line-of-sight restrictions

Due to the electromagnetic measuring principle, the instruments do not require a line of sight to an optical camera. They can be handled easily and in an ergonomic fashion.

Autoclavable and reusable instruments

All instruments can be sterilized many times by autoclave. Because of the high quality build, there are no special costs incurred by single-use components or instruments that can be sterilized only a few times.

High-quality material

The instruments are manufactured with state-of-the art, high-quality material, e. g. rigid and light titanium, surgical stainless steel, PEEK or bendable and kink-resistant nitinol. The material-selection of all instruments fulfills strict medical requirements.

High mobility

The extra long connection cable (2.6 m) enables a high degree of flexibility for the OP setup. The navigation system can be positioned at a greater distance from the operating table.

Automatic instrument verification and (optional) calibration

The instrument’s integrity and accuracy are automatically checked during each registration process. Instruments with larger manufacturing tolerances can be calibrated automatically by the navigation software during the instrument registration process. This ensures precise navigation while keeping manufacturing costs low.

Platform-independent, modular software

Our navigation software is based on highly modular libraries, which we have developed over the years, and which contain all basic functionality, such as instrument tracking, DICOM import-export, processing of medical image data, PACS/network interfaces, etc.

The software is built upon platform-independent libraries and runs on Windows and Linux systems, including the Raspberry Pi.

Plug-and-play optical and electromagnetic tracking

Navigation works out of the box with optical and electromagnetic tracking technology.

• Common tracking API for optical and electromagnetic measurement systems
• Easy integration of new instruments
• Instrument registration and instrument calibration with automatic length/geometry adjustment

Connectivity and data import/export

• Large variety of import options
• 2D X-ray images in DICOM 3 format and all standard image formats, like. BMP, TIF, JPEG, PNG, GIF
• 3D CT/MRI/CBCT datasets in DICOM 3 format including image-compression like RLELossless, JPEGBaseline, JPEGExtended, JPEG2000, etc..
• 4D temporal datasets in DICOM 3 format (e.g. beating heart)
• Import sources include CD, DVD, USB and Network
  • Encrypted SMB 3 shares
  • DICOM PACS Query/Retrieve
  • DICOM PACS SCP Server
  • DICOM-TLS Encryption
• Connect live video sources via framegrabbers
• Connect Navigated Camera Assist and Navigated Control Unit
• Connect our Raambo robot platform

Flexible GUI design

• Theming support - easily adjust the user-interface to your corporate design
• Animations, modern, fluent design
• Arbitrary mix of 2D and 3D content, including semi-transparent overlays
• Arbitrary view layouts
• Multiple languagues, quick and easy internationalization
• Multi-touch support, pinch to zoom

2D, 3D, 4D Medical Visualization

Our software offers a multitude of high-quality visualization options. 2D, 3D and 4D medical image display as well as live-video integration and augmentation are supported.

All visualizations are hardware-accelerated using modern OpenGL and shaders for GPU programming.

• 2D DICOM slices
• 2D X-rays
• 2D Panoramic views
• 3D Isosurface extraction and rendering
• 3D Volume Rendering with lighting and transfer functions
• 4D DICOM datasets (e.g. beating heart)
• Digitally Reconstructed Radiographs (DRR)
• Virtual Endoscopy
• Augmented Reality Endoscopic Video
• 3D Stereo Display

Live-video integration and augmented reality

We use hardware-accelerated Direct Memory Access (DMA) with OpenGL Pixel Buffer Objects for low-latency video-integration.

This way live video streams can be seamlessly integrated into 2D and 3D scenes, processed and augmented with medical image data.

Our API supports a large variety of framegrabbers, e.g. AVerMedia, Datapath, Epiphan, Magewell, VRmagic, Yuan.

Sophisticated planning features

• Risk structures
• Automatic path planning for ENT surgery
• Trajectory planning for ENT, Neuro and Spine applications
• Implant planning and primary stability estimation for dental and spine applications
• Semi-automatic vessel segmentation and path planning for intra-vascular surgeries

Fast and easy patient registration

• Manual point-based registration
• Surface matching with touch and touchless surface acquisition
• Fully automatic registration of intraoperative 2D X-ray images in Spine and Cardiac surgery
• Fully automatic registration of intraoperative 3D datasets in Spine and Dental applications
• Semi-automatic optimization of patient-registration

Maximum mobility

The whole robot weights only 4 kg - this includes the base with the suction cups and the battery pack!

Raambo can easily be picked up by hand and moved around.

All power and control electronics are built directly into the robot. The entire robot is battery-powered and self-contained; no bulky external components are required.

Super strong

Despite its light weight the Raambo robot is a small powerhouse. It can lift up to 2.5 kg on an outstretched arm.

Highest flexibility due to modular design

The modular 3D-printed design of the Raambo robot allows individual customization and fast adaptation to your needs.

USB and Bluetooth connection

The robot can simply be connected to any computer via USB. This allows control without programming knowledge using simple commands via a terminal. In addition to the USB connection, control via Bluetooth and WLAN is also possible using small additional modules.

Fast and easy teaching

With the simple teaching mode, the robot can be programmed in a matter of seconds. And this can also be done by non-technical people - in other words, by anyone.

Easy integration of navigation

By attaching our optical marker spheres to the end effector and/or the robot's limbs, the robot is able to adaptively track hand-held instruments to the patient's movement or align them with other instruments. Thanks to the modular design, this is possible within a very short time.