Stereotactic Navigation for Primary Spine and Pelvis Tumour Resection and Reconstruction: A Narrative Review

Abstract

Spine, sacrum, and pelvic primary tumours are uncommon but are biologically aggressive and for these en bloc resection with clear margins is still the most important factor in achieving local control and long-term survival. Because of the complicated three-dimensional anatomy of these areas — which includes dense neurovascular structures, visceral organs and irregular bony pathways — it has always been difficult to turn the careful preoperative planning into an equally accurate intraoperative cut. Stereotactic (image-guided) navigation, which has long been used in the placement of pedicle screws during degenerative spine surgery, is now being increasingly used as a tool in oncology to assist with osteotomies and to carry out the preoperative resection plans in real time. This review brings together the current body of evidence — based on a 2026 systematic review of 21 studies and 240 patients — regarding the use of navigation in spine and pelvic tumour surgery, the results that have been reported, and the future direction of the technology.