Augmented Reality in Spinal Surgery: Highlights From Augmented Reality Lectures at the Emerging Technologies Annual Meetings

Abstract

Introduction Augmented reality (AR) is an advanced technology and emerging field that has been adopted into spine surgery to enhance care and outcomes. AR superimposes a three-dimensional computer-generated image over the normal anatomy of interest in order to facilitate visualization of deep structures without the ability to directly see them. Objective To summarize the latest literature and highlight AR from the annual “Spinal Navigation, Emerging Technologies and Systems Integration” meeting lectures presented by the Seattle Science Foundation (SSF) on the development and use of augmented reality in spinal surgery. Methods We performed a comprehensive literature review from 2016 to 2020 on PubMed to correlate with lectures given at the annual “Emerging Technologies” conferences. After the exclusion of papers that concerned non-spine surgery specialties, a total of 54 papers concerning AR in spinal applications were found. The articles were then categorized by content and focus. Results The 54 papers were divided into six major focused topics: training, proof of concept, feasibility and usability, clinical evaluation, state of technology, and nonsurgical applications. The greatest number of papers were published during 2020. Each paper discussed varied topics such as patient rehabilitation, proof of concept, workflow, applications in neurological and orthopedic spine surgery, and outcomes data. Conclusions The recent literature and SSF lectures on AR provide a solid base and demonstrate the emergence of an advanced technology that offers a platform for an advantageous technique that is superior, in that it allows the operating surgeon to focus directly on the patient rather than a guidance screen.

Feasibility and Accuracy of Thoracolumbar Pedicle Screw Placement Using an Augmented Reality Head Mounted Device

“…While conventional surgical navigation systems typically use screens to provide information in the standardized perspectives common for radiology, AR-solutions are inherently different and lend themselves to presenting information from the perspective of the surgeon [14][15][16][17]. To date, four different interfaces for AR-navigation have been presented [13,18]. Projector based AR was first described in the early 2000s and the first system for spinal navigation was presented in 2020 [19][20][21].…”

“…However, this method is best suited for intra-and extradural tumor surgery and not optimized for pedicle screw placement [22]. Since their introduction, Head-mounted-AR devices have gained attention due to their ability to present information without interrupting the surgeon's line of sight and causing undue attention shifts [18,23]. Consequently, several head-mounted devices (HMD) using augmented reality navigation are available on the market today.…”

The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States

“…Navigation is another add-on technology with similar goals of improving patient outcomes by reducing inaccuracies in the surgical approaches and techniques thought to be the source of higher complication and revision surgery rates [ 74 , 75 , 76 , 77 , 78 ]. Depending on the application, navigation and augmented reality (AR) may be utilized separately or together [ 79 , 80 , 81 , 82 ]. Both technologies aim at more accurately navigating complex structures during surgery.…”

Process management of ergonomic workplace based on augmented reality principles

“…The author (Morgere, 2014) has used AR in shipping where with the help of interactive glasses and mobile application, it can easily identify the type and exact location of approaching objects. Or in the context of healthcare, AR is mainly applied as a means to train difficult and demanding operations where the precision and sequence of individual movements are crucial to success (Tagaytayan, 2018;Yoo, 2019;Uddin, 2021). Within this sub-category, I would like to highlight the work of (Aly, 2021) where AR was first used for vascular surgery, using a smartphone with a camera and gyroscopic sensors as a tool.…”