December 21, 2025 | 07:15 am
TEMPO.CO, Jakarta - With the rapid development of medical technology, achieving precision and ensuring patient safety has become crucial in every surgical procedure, especially in the field of neurosurgery. The innovation of modern surgical tools and techniques allows doctors to work more precisely while minimizing the risk of complications. This is particularly important in spinal surgery, known as one of the most complex procedures involving the central nervous system and the main supporting structures of the human body. High precision is essential to maintain nerve function and optimize the postoperative quality of life for the patient.
One of the innovations that has garnered attention is spinal neuronavigation technology, a system that supports spinal surgery and is designed to improve the accuracy of surgical procedures while reducing the risk of errors. Wawan Mulyawan, a neurosurgery specialist at Jakarta Hospital in Indonesia, explained that Spinal Neuronavigation is used in the preoperative stage to map the nerve area in detail, including in cases involving the spine. "This technology works like a navigation system or GPS that helps the doctor determine the safest and most precise surgical route, allowing for smaller incisions, a minimally invasive procedure, and an expected faster patient recovery process," he said at Jakarta Hospital in mid-December 2025.
According to Wawan, the complexity of the anatomy of the spine, which experiences extreme rotation and curvature, remains a challenge. Conventional anatomical landmarks are often difficult to recognize or even disappear. Neuronavigation technology in the placement of pedicle screws on the vertebra guides the screw trajectory to be accurately positioned within the pedicle (bridge of bone), avoiding the risk of the screws penetrating the nerve canal (which can cause paralysis) or injuring major blood vessels around the aorta. Furthermore, this technology also assists in planning derotation strategies to restore the body's balance (sagittal and coronal balance) physiologically.
Spinal surgery procedures are known to present microscopic challenges, especially in cases of Herniated Nucleus Pulposus (HNP) and spinal stenosis, demanding very high accuracy due to the narrow surgical area and its proximity to vital nerves. "This technology also helps determine the amount of lamina bone to be removed (laminotomy) to free the nerves without disturbing the stability of the spine," said Neurosurgery Specialist Dr. Dimas Rahman Setiawan. He noted that the effectiveness of using this technology approaches 100% due to its high accuracy and precision in surgery.
Additionally, this technology reduces the risk of iatrogenic injuries and bleeding, as surgical instruments can be tracked in real-time on a monitor screen with sub-millimeter accuracy. This approach also allows for a faster patient recovery process."
Dimas added that Neuronavigation technology also functions like an intraoperative GPS system, mapping the patient's anatomy in real-time in three dimensions (3D). "This technology enables doctors to 'see' the structures behind the bones without having to perform wide muscle dissection," he said.
Neurosurgery Specialist Dr. Danu Rolian also discussed the management of vertebral compression fractures in the spine, commonly caused by osteoporosis or trauma. This condition often results in severe pain and a decrease in the patient's quality of life. Danu explained that one commonly used treatment is Kyphoplasty, a minimally invasive technique that involves injecting special bone cement to strengthen and restore the height of the collapsed spinal segment, while also relieving pain. Although it is minimally invasive, this procedure still carries the risk of cement leakage into the nerve canal if performed without precise visual guidance.
According to him, Neuronavigation technology can improve needle path accuracy, ensuring that the balloon kyphoplasty needle enters the center of the vertebral body (corpus vertebrae) symmetrically from the left and right sides. Furthermore, precise balloon placement can optimally restore the height of the collapsed spine, preventing permanent kyphosis (hunchback) in the future.
Budi Sampurna, the Chair of the Jakarta Hospital Foundation, added that the implementation of spinal neuronavigation is not just a matter of following technological trends but a commitment from the hospital to provide high patient safety standards.
APRILIAN RODO RIZKY
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