Development of the Computer Assisted Neurosurgery (CANS)

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Recent progress in computer and imaging technology not only has provided neurosurgeons with improved methods for diagnosis such as computerized tomography (CT) and magnetic resonance imaging (MRI) but also has opened up new avenues for investigation into ancillary instrumentation for surgical procedures. To make available precise spatial information of CT or MR images for the actual operative procedure, we have developed a computer-assisted neurosurgical navigational system (CANS navigator), which indicates the active point of surgical manipulation on the preoperative CT or MR images. The system consists of a 3 dimensional digitizer, a personal computer, and an image processing unit. The 3 dimensional digitizer utilizing recently developed magnetic field modulation technology determines the spatial position and orientation angles of the resin probe, triangle-shaped pointer, or suction tube with an attached small magnetic field sensor. Four fiducial markers on the scalp were used to translate the spatial data of the probe onto the preoperative CT or MR images of the patient. This frameless and armless navigational system introduces CT or MRI-stereotaxy to conventional open neurosurgery without limiting the operative field or interfering with the surgical procedures. In the near future, we hope not only to improve the accuracy of this neurosurgical navigational system, but also to combine functional-anatomical data base more closely with the surgical procedures to develop a safe and precise computer-assisted neurosurgery.