Needle Navigation; a New Era in the Interventional Pain Practice: A Narrative Review

Abstract

Background: The hazardous effects of x-ray based technologies and shortcomings of other imaging systems like ultrasound have raised attention to create a new guiding system for interventional practice. After the introduction of virtual reality, the next challenge was how to implement it in the medical guiding systems. Medical engineering used registration aligned features of one imaging modality with real anatomical points and merged them into one single hybrid model. This augmented reality made the foundation and provided a level surface for the construction of every other new level. The next level was how to track a device in this augmented reality, which was accomplished with trackers and registration. To overcome the shortcomings of each imaging modality, the solution was fusion imaging, the combination of more than one modality to overcome the limitations of each. Nowadays, this fusion imaging plus needle tracking is the most sophisticated of navigational systems that interventionists work with. Despite clinical improvements in other medical fields like neurosurgery and urology, most of the work in the interventional pain practice has been done on phantom models and human cadavers, and there is still low experience in clinical studies about this new guiding system. Methods: The electronic search for this review included full text English article between 1990-2021 in PubMed and Google Scholar databases. The terms that have been searched are: “virtual reality”, “augmented reality”, “needle navigation”, “needle tracking”, and “fusion imaging”. Results: The navigation imaging guided system can be a practical, safe, efficient, reproducible, feasible guiding option for interventional pain procedure. Conclusions: The navigation based interventional injection is a new era in the interventional pain practice and can omit X-ray based hazardous.