Instrumentation and methods are provided for performing image-guided spinal surgery using an anterior surgical approach. In one embodiment, the method comprises providing a surgical navigation reference device, mounting the reference device to bone at a location remote from the spinal column and in a substantially fixed position relative thereto, accessing a portion of the spinal column from an anterior direction, and performing an image-guided surgical procedure on the spinal column using an anterior surgical approach. In another embodiment, the mounting of the reference device comprises anchoring the reference device to a portion of the patient's pelvic bone, and more specifically the anterior region of the iliac crest. In a further embodiment, the image-guided surgical procedure comprises a spinal implantation procedure wherein a spinal implant is inserted into an intervertebral opening formed along the lumbar region of the spinal column using an anterior surgical approach.