Head-mounted display augmented reality to guide pedicle screw placement utilizing computed tomography

Gibby, Jacob T.; Swenson, Samuel A.; Cvetko, Steve; Rao, Raj R.; Javan, Ramin

doi:10.1007/s11548-018-1814-7

Cited by 157 publications

(160 citation statements)

References 52 publications

Supporting

Mentioning

155

Contrasting

Order By: Relevance

“…Moreover, Table 3 shows significant improvement of total TED values in attempt 2 when compared to attempt 1, regardless of scenario. We also find that each experimental round was not time consuming, not taking more than 4 min, where similar timing has also been presented in other studies [32,43]. Table 3 also presents that there was no statistical difference in completion time between the two attempts.…”

Section: Discussionsupporting

confidence: 86%

Value of the surgeon’s sightline on hologram registration and targeting in mixed reality

et al. 2020

View full text Add to dashboard Cite

Purpose Mixed reality (MR) is being evaluated as a visual tool for surgical navigation. Current literature presents unclear results on intraoperative accuracy using the Microsoft HoloLens 1®. This study aims to assess the impact of the surgeon’s sightline in an inside-out marker-based MR navigation system for open surgery. Methods Surgeons at Akershus University Hospital tested this system. A custom-made phantom was used, containing 18 wire target crosses within its inner walls. A CT scan was obtained in order to segment all wire targets into a single 3D-model (hologram). An in-house software application (CTrue), developed for the Microsoft HoloLens 1, uploaded 3D-models and automatically registered the 3D-model with the phantom. Based on the surgeon’s sightline while registering and targeting (free sightline /F/or a strictly perpendicular sightline /P/), 4 scenarios were developed (FF-PF-FP-PP). Target error distance (TED) was obtained in three different working axes-(XYZ). Results Six surgeons (5 males, age 29–62) were enrolled. A total of 864 measurements were collected in 4 scenarios, twice. Scenario PP showed the smallest TED in XYZ-axes mean = 2.98 mm ± SD 1.33; 2.28 mm ± SD 1.45; 2.78 mm ± SD 1.91, respectively. Scenario FF showed the largest TED in XYZ-axes with mean = 10.03 mm ± SD 3.19; 6.36 mm ± SD 3.36; 16.11 mm ± SD 8.91, respectively. Multiple comparison tests, grouped in scenarios and axes, showed that the majority of scenario comparisons had significantly different TED values (p < 0.05). Y-axis always presented the smallest TED regardless of scenario tested. Conclusion A strictly perpendicular working sightline in relation to the 3D-model achieves the best accuracy results. Shortcomings in this technology, as an intraoperative visual cue, can be overcome by sightline correction. Incidentally, this is the preferred working angle for open surgery.

show abstract

Section: Discussionsupporting

confidence: 86%

Value of the surgeon’s sightline on hologram registration and targeting in mixed reality

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Another study by Gibby J. T. et al [44] also investigated pedicle screw placement while using Microsoft HoloLens (Microsoft, Redmond, WA). In a lumbar saw bone model, they placed 36 needles, representing the pedicle screws.…”

Section: Instrument / Implant Placementmentioning

confidence: 99%

Applicability of augmented reality in orthopedic surgery – A systematic review

Jud

Fotouhi

Andronic

et al. 2020

BMC Musculoskelet Disord

129

View full text Add to dashboard Cite

Background: Computer-assisted solutions are changing surgical practice continuously. One of the most disruptive technologies among the computer-integrated surgical techniques is Augmented Reality (AR). While Augmented Reality is increasingly used in several medical specialties, its potential benefit in orthopedic surgery is not yet clear. The purpose of this article is to provide a systematic review of the current state of knowledge and the applicability of AR in orthopedic surgery. Methods: A systematic review of the current literature was performed to find the state of knowledge and applicability of AR in Orthopedic surgery. A systematic search of the following three databases was performed: "PubMed", "Cochrane Library" and "Web of Science". The systematic review followed the Preferred Reporting Items on Systematic Reviews and Meta-analysis (PRISMA) guidelines and it has been published and registered in the international prospective register of systematic reviews (PROSPERO). Results: 31 studies and reports are included and classified into the following categories: Instrument / Implant Placement, Osteotomies, Tumor Surgery, Trauma, and Surgical Training and Education. Quality assessment could be performed in 18 studies. Among the clinical studies, there were six case series with an average score of 90% and one case report, which scored 81% according to the Joanna Briggs Institute Critical Appraisal Checklist (JBI CAC). The 11 cadaveric studies scored 81% according to the QUACS scale (Quality Appraisal for Cadaveric Studies). Conclusion: This manuscript provides 1) a summary of the current state of knowledge and research of Augmented Reality in orthopedic surgery presented in the literature, and 2) a discussion by the authors presenting the key remarks required for seamless integration of Augmented Reality in the future surgical practice. Trial registration: PROSPERO registration number: CRD42019128569.

show abstract

“…A similar experimental setup was utilized for lumbar pedicle screw placement simulated by Kirschner wires inser-tion. Visualization of the spine hologram through the HoloLens resulted in > 90% correct screw placement with faster insertion times [62][63][64] and no significant difference in accuracy between ARnavigated screw placement and conventional navigation. 65 Comparable outcomes were reported in a cadaveric study conducted by Urakov et al 66 comparing the accuracy of screw placement with either AR or traditional fluoroscopic guidance.…”

Section: Augmented Reality In Spine Surgerymentioning

confidence: 96%

Robotic Spine Surgery and Augmented Reality Systems: A State of the Art

et al. 2020

View full text Add to dashboard Cite

Instrumented spine procedures have been performed for decades to treat a wide variety of spinal disorders. New technologies have been employed to obtain a high degree of precision, to minimize risks of damage to neurovascular structures and to diminish harmful exposure of patients and the operative team to ionizing radiations. Robotic spine surgery comprehends 3 major categories: telesurgical robotic systems, robotic-assisted navigation (RAN) and virtual augmented reality (AR) systems, including AR and virtual reality. Telesurgical systems encompass devices that can be operated from a remote command station, allowing to perform surgery via instruments being manipulated by the robot. On the other hand, RAN technologies are characterized by the robotic guidance of surgeon-operated instruments based on real-time imaging. Virtual AR systems are able to show images directly on special visors and screens allowing the surgeon to visualize information about the patient and the procedure (i.e., anatomical landmarks, screw direction and inclination, distance from neurological and vascular structures etc.). The aim of this review is to focus on the current state of the art of robotics and AR in spine surgery and perspectives of these emerging technologies that hold promises for future applications.

show abstract

Head-mounted display augmented reality to guide pedicle screw placement utilizing computed tomography

Abstract: To our knowledge, this is the first peer-reviewed report and evaluation of HMD-AR with superimposed 3D guidance utilizing CT for spinal pedicle guide placement for the purpose of cannulation without the use of fluoroscopy.

Cited by 157 publications

References 52 publications

Value of the surgeon’s sightline on hologram registration and targeting in mixed reality

Value of the surgeon’s sightline on hologram registration and targeting in mixed reality

Applicability of augmented reality in orthopedic surgery – A systematic review

Robotic Spine Surgery and Augmented Reality Systems: A State of the Art

Contact Info

Product

Resources

About