A surgical hardware and software monitoring system and method allows for surgical planning while the patient is available for surgery, for example while the patient is being prepared for surgery so that the system may model the surgical site. Tracker (508, 610) obtains image information, with controller (210) configured to spatially relate image information with previously obtained scan data. Fiducial reference (10) is configured for removably attaching to a location proximate a surgical site. The fiducial reference is observable by the tracker so that software of the controller determines three dimensional location and orientation based on scan data and image data of the surgical site (600), spatially relating the image information to the scan data to determine the three-dimensional location and the orientation of the fiducial reference.
