3D spinal navigation provides a unique opportunity to model the patient’s spinal canal on a computer screen while operating. Preoperatively a high-resolution CT scan is taken, to identify the patient’s spinal anatomy. In surgery, points are made to match the CT scan. Common landmarks are transverse process tips and spinous processes. This example (Stryker Navigation® Mahwah, NJ) shows the guided placement of a pedicle screw into the pedicle of the spine.