Fluoroscopic navigation is an important advance in spine surgery that allows surgeons to track their instruments in real time relative to multiplanar fluoroscopic images. There are currently two types of fluoroscopic navigation that are available: virtual fluoroscopy, which uses a conventional C-arm fluoroscope; and three-dimensional fluoroscopy, a strategy that also allows imaging in the axial plane. In addition to potentially decreasing radiation exposure, these modalities may also increase the safety and accuracy of spinal instrumentation. This article discusses the technical aspects of fluoroscopic navigation and reviews the literature regarding the indications for its use with spinal procedures.
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