Navigated Spine Surgery for Central Valley Patients

Care is in Fresno

Central Valley Advanced Spine has one office, in Fresno, California. Patients who live in other Valley cities travel to Fresno for their consultation, surgery and follow-up visits. There are no satellite offices. Navigation is used inside another operation, most often a fusion, so the trip and the recovery depend on that main surgery.

How navigation works

After you are asleep and positioned on the operating table, a 3D scan of your spine is taken in the room. A camera system tracks the surgeon's instruments and shows exactly where they are on that scan, from several angles at once. The main use is placing screws into the spine during a fusion, where accuracy near nerves and blood vessels matters. It also helps in minimally invasive surgery, where the surgeon works through smaller openings and cannot see the whole spine.

Some systems add a robotic arm. The surgeon plans the path of each screw on the 3D image, and the arm holds the guide on that path. The surgeon performs the operation; the arm does not act on its own. The 3D scan uses radiation, which we discuss with you. More detail is on our navigated and robotic spine surgery page.

A first at Saint Agnes

In 2026, Saint Agnes Medical Center in Fresno reported that Dr. Devan Higginbotham performed the first spine procedure there using the Mako 4 robotic system, which combines surgical planning, robotic guidance and 3D imaging. His research also includes a review of virtual and augmented reality in spine surgery, published in 2023. Whether navigation, a robotic arm or neither is used in your case depends on your anatomy and the hospital where your surgery is scheduled.

Who may need a navigated operation

• People who need a fusion for a slipped, unstable vertebra
• Adults with a curve or forward tilt of the spine that needs correction
• Patients with collapsed, worn discs and instability
• People with lumbar stenosis that needs both decompression and stabilizing
• Spines with prior surgery or unusual anatomy, where landmarks are harder to see

Planning a fusion from another city

A fusion usually includes at least one night in the hospital and several follow-up visits with x-rays over the first year. For patients outside Fresno:

• Send imaging early. MRI, CT and x-rays from your local hospital or imaging center, as images and reports.
• Do what you can near home. Lab work and some health checks can often be done with your own doctor.
• Bone health first. Weak bone can loosen screws. Low bone density is often treated before surgery.
• Arrange drivers. You will need rides for surgery and for early follow-up visits while you are not driving.
• Local therapy. If you need physical therapy, a clinic near home is usually fine.

For the weeks after surgery, see recovery after spine surgery.

Related procedures by city

We do not have separate city pages for navigated surgery, because navigation is part of a larger operation. Most navigated cases are fusions, including many deformity corrections. The city pages for adult deformity correction describe the trip to Fresno from each city. Distances are approximate, city center to city center.

• Fresno Our office
• Clovis about 9 miles
• Visalia about 44 miles
• Modesto about 95 miles
• Bakersfield about 109 miles

Endoscopic surgery by city:

• Fresno endoscopic surgery
• Clovis endoscopic surgery
• Visalia endoscopic surgery
• Modesto endoscopic surgery
• Bakersfield endoscopic surgery

Cervical disc replacement by city:

• Fresno neck disc replacement
• Clovis neck disc replacement
• Visalia neck disc replacement
• Modesto neck disc replacement
• Bakersfield neck disc replacement

See all of them on the locations page.

Questions about navigated surgery