Caduceus S — Navigation

Spinal navigation, on the imaging you already own

Caduceus S is a 3D computer navigation system for spinal surgery. It reads the imaging your operating room already produces — a standard 2D C-arm, a 3D C-arm or an intraoperative CT — and turns it into live guidance accurate to within 2 mm, without a preoperative CT scan and without a room full of extra equipment.

Licensed by Taiwan's TFDA as medical devices No. 007161 and No. 007725.

What it is

Why a spine surgeon needs navigation at all

Minimally invasive spinal surgery asks the surgeon to reach complex and delicate structures through a narrow field of view and a small working space. Navigation is what makes that reasonable: guided to the lesion directly, the surgeon does less damage to healthy tissue on the way in, and the accuracy of the approach stops depending on how much of the anatomy is exposed.

One system, whatever imaging is in the room

Caduceus S does not ask a hospital to replace its imaging. Three modules cover the three things a spine theatre is likely to already have — a plain 2D C-arm, a 3D C-arm, or an intraoperative CT — and each one registers the patient from images taken on that device. Nothing is bolted onto the existing equipment and the operating environment does not have to change.

Preoperative planning runs on the same workstation: load the DICOM data, simulate the approach beforehand, and have that plan on screen during the case.

Applicable across spinal implant surgery — scoliosis correction, spondylolisthesis, vertebral fracture and spinal fixation — as well as spinal tap procedures and minimally invasive spine surgery generally.

  • Scoliosis
  • Spondylolisthesis
  • Vertebral fracture
  • Spinal fixation
  • Spinal tap
  • Minimally invasive spine surgery
The Caduceus S navigation cart: a wheeled green-and-white trolley carrying a
                  large touchscreen workstation, with a tracking camera on an arm above it.

Ultra-precise positioning

The system reports the position of the instrument and its distance, direction and angle to the lesion throughout the case, with an error under 2 mm.

Minimally invasive by design

Locating the lesion quickly and confirming the instrument against it keeps the incision small — roughly 2 to 3 cm for a single segment, against the 5 to 10 cm an open approach needs.

Great compatibility

No auxiliary hardware has to be fitted to the existing imaging equipment, and the operating environment does not have to be rebuilt around the system.

Preoperative planning

DICOM data loaded into the navigation system supports simulation before the case, and that plan is displayed alongside the live imaging during it.

2mm Positioning Error, Under
10 min Typical Setup Time
2–4 X-ray Images Per Case

Three configurations

Pick the module that matches your imaging

The three modules are the same navigation system reading three different sources. What changes between them is how the patient is registered, how much X-ray the case costs, and which kind of operating room they suit. All three work with the Caduceus S AR glasses.

Aspect 2D C-arm module 3D C-arm module Intraoperative CT module
Imaging source A standard 2D C-arm A 3D C-arm An O-arm intraoperative CT
Registration Simplified registration from the C-arm images themselves Automatic, once the 3D scan is complete Automatic, once the CT scan is complete
X-ray images taken About 2 to 4 for the whole case No further C-arm shots after the scan No further C-arm shots after the scan
Equipment compatibility A wide range of C-arm brands, using what is already in the room Various registration tools; DICOM loaded straight into the workstation O-arm, with no extra connections or configuration
Best suited to Outpatient and ambulatory surgery centres already running a C-arm Complex cases — four or more vertebrae, small curvatures or rotation Mid- to high-end operating rooms, including deformity such as scoliosis
Works with the AR glasses Yes Yes Yes

All three columns are Caduceus S configurations, not competing products. Which one fits is a question about the imaging you already own, not about which is better.

Module 01

2D C-arm module

The 2D C-arm module runs spinal navigation from plain 2D fluoroscopy. It connects to a wide range of C-arm equipment already in use, which is what makes navigation possible in rooms where it has traditionally been out of reach.

Navigation with just a standard C-arm

Outpatient and ambulatory surgery centres run a great deal of spinal surgery, and most of them do it without navigation — not because they do not want it, but because their equipment will not carry it. This module removes that barrier: no complex setup, no additional imaging device, accurate guidance from the C-arm that is already parked in the room.

  • Supports multiple C-arm brands — existing equipment is used as it stands, with no additional purchase and no complex configuration
  • Fast and easy operation — a straightforward interface that fits the current workflow, so the team starts navigating without a long learning curve
  • Simplified imaging process — registration is quicker, which takes time out of the setup and out of the case
  • Reduced radiation exposure — fewer C-arm shots are needed, which is safer for the patient and for everyone standing in the room

From the operating room

Hear it from Dr. Hua, San Francisco

A neurosurgeon practising across the greater San Francisco and San Jose Bay Area talks through what changes when spinal navigation arrives in an outpatient surgery centre: how surgery centres differ from hospitals, why radiation is the complaint that keeps coming up in minimally invasive work, and how the system performs in his own cases.

Module 02

3D C-arm module

Where the anatomy is complicated, a 3D volume beats two flat views. This module takes the 3D C-arm scan, registers it automatically and drives navigation from it — which is what makes it the right choice for four or more levels, small curvatures, or a rotated vertebra.

Navigating on the 3D volume

The reconstructed volume, the planned trajectory and the instrument position sit on one screen, so the approach is checked against the anatomy rather than inferred from two projections.

Quick 3D image conversion

The scan is converted and brought into the workflow fast enough that it does not interrupt the procedure it is meant to guide.

Registration, simplified

Various registration tools are supported, and DICOM images load straight into the navigation workstation — so the case continues without going back for more C-arm imaging.

Fast conversion

3D images are converted efficiently and folded into the surgeon's workflow with minimal disruption to the procedure.

Simplified registration

The system supports a range of registration tools and integrates smoothly with the 3D C-arm, with DICOM loaded directly into the navigation workstation.

Automatic registration

Once the 3D scan finishes, the software registers the images itself — removing the traditional C-arm shots and the extra imaging that goes with them.

Built for complex cases

Four or more vertebrae, small curvatures or rotations such as L3 and L4 — the cases where precise navigation matters most.

Module 03

Intraoperative CT module

The intraoperative CT module pairs Caduceus S with an O-arm. The scan is taken in theatre, on the patient as they are positioned, and the navigation runs on that — real-time imaging with the accuracy of CT, and the surgeon's attention still on the patient.

Automatic registration from the scan

The O-arm captures a real-time CT of the surgical area and the system registers it itself. No additional C-arm imaging, and less time spent acquiring images at all.

No excess equipment

Nothing else has to be connected or configured. 3D imaging joins the surgical workflow rather than being bolted onto the side of it.

For mid- to high-end theatres

Suited to a range of surgical settings, from mid-level operating rooms up to the most advanced facilities.

Precision where anatomy is deformed

Particularly useful in complex spinal work such as scoliosis, where the margin for error is smallest; X-ray images can be brought into the navigation alongside the CT.

Ultra-low radiation

Two to four images, and no CT beforehand

Traditional spinal surgery tends to take a CT before the operation and more imaging during it. Caduceus S needs neither: the initial 2 to 4 X-ray images taken in theatre are enough to navigate a minimally invasive case.

Why the image count matters

Radiation dose is cumulative, and the long-term risk it carries rises with it, which is why imaging that is not needed should not be taken. For scale: local authorities cap the dose a member of the public should receive in a year at 5 millisieverts, and a single CT scan is roughly 1.5 to 2 millisieverts of that budget — before the patient has reached the operating table at all.

  • No preoperative CT — the scan that would normally be taken before surgery is not required, so its dose is never delivered
  • No additional intraoperative CT — the whole case can be navigated from the C-arm images already taken
  • A shorter route to theatre — after the outpatient consultation the patient can go straight to the operating room, and after a minimally invasive case can be discharged the same day
A two-panel illustration. Left, labelled tradition: a draped patient
                  surrounded by half a dozen separate fluoroscopy images. Right, labelled
                  reduced radiation exposure: the same procedure with a single pair of images
                  and the surgeon wearing a Caduceus S headset.

Optional integration

Add the AR glasses, and the monitor stops mattering

Every one of the three modules can be paired with the Caduceus S AR glasses. The navigation image then appears in the surgeon's own field of view instead of on a screen across the room — the same guidance, without the glance away from the wound.

The same navigation, in the line of sight

  • No need to turn their heads — critical navigation data is displayed where the surgeon is already looking, so attention stays on the patient
  • Real-time 3D superimposition — with the 3D C-arm and intraoperative CT modules the volume is laid over the patient as they lie on the table, which is where complex navigation is hardest to do from a screen
  • Shorter procedures — an uninterrupted flow of information means fewer pauses, and a case that finishes sooner
Two surgeons in gowns and masks stand at a draped operating table. One wears
                  a Caduceus S headset and holds an instrument, with a translucent navigation
                  panel showing spine imaging floating in front of him.

Navigation that fits the room you have

Tell us what imaging you already own

A 2D C-arm, a 3D C-arm or an intraoperative CT — whichever it is, there is a Caduceus S module that runs on it. Tell us what is in your theatre and the procedures you do most often, and we will show you the configuration that fits, online or on site.