This paper provides a detailed report of the "First Annual Spinal Navigation, Emerging Technologies and Systems Integration" meeting held December 3, 2016 at the Seattle Science Foundation.

The burden of orthopaedic trauma in the developing world is substantial and disproportionate. SIGN Fracture Care International is a nonprofit organization that has developed and made available to surgeons in resource-limited settings an intramedullary interlocking nail for use in the treatment of femoral and tibial fractures. Instrumentation also is donated with the nail. A prospectively populated database collects information on all procedures performed using this nail. Given the challenging settings and numerous surgeons with varied experience, it is important to document adequate alignment and union using the device.

The clinical practice of spine navigation has rapidly grown with the development of image-based guidance. In this paper, a brief history of spinal navigation is presented and a review of clinical outcomes for 12 622 pedicle screws placed using the latest technology in the sacral, lumbar and thoracic regions. The clinical evidence demonstrate that intraoperative 3D image guided surgery has a 96.8% success rate. A concluding section detailing existing barriers that limit more widespread adoption and future development efforts is presented.

Dartmouth and Medtronic Navigation have established an academic-industrial partnership to develop, validate, and evaluate a multi-modality neurosurgical image-guidance platform for brain tumor resection surgery that is capable of updating the spatial relationships between preoperative images and the current surgical field. A stereovision system has been developed and optimized for intraoperative use through integration with a surgical microscope and an image-guided surgery system. The microscope optics and stereovision CCD sensors are localized relative to the surgical field using optical tracking and can efficiently acquire stereo image pairs from which a localized 3D profile of the exposed surface is reconstructed. This paper reports the first demonstration of intraoperative acquisition, reconstruction and visualization of 3D stereovision surface data in the context of an industry-standard image-guided surgery system. The integrated system is capable of computing and presenting a stereovision-based update of the exposed cortical surface in less than one minute. Alternative methods for visualization of high-resolution, texture-mapped stereovision surface data are also investigated with the objective of determining the technical feasibility of direct incorporation of intraoperative stereo imaging into future iterations of Medtronic's navigation platform.

Cementless femoral fixation is the current goldstandard in revision hip arthroplasty. The purpose of this study is to report the long-term survivorship and clinical outcome of a titanium, long-stemmed, calcar-replacement femoral component from an independent centre.

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.