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J Neurol Surg A Cent Eur Neurosurg
DOI: 10.1055/a-2200-3585
Original Article

A Novel pedicle screw placement Surgery Based on Integration of Surgical guides and Augmented Reality

Huiyang Kong
1   School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China (Ringgold ID: RIN47863)
,
Shuyi Wang
2   School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China (Ringgold ID: RIN47863)
,
Can Zhang
3   Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China (Ringgold ID: RIN71044)
,
Zan Chen
4   Neurosurgery, Xuanwu Hospital Department of Neurosurgery, Beijing, China (Ringgold ID: RIN572255)
5   INI, China International Neuroscience Institute, shanghai, China
,
Zhanglei Wu
6   School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China (Ringgold ID: RIN47863)
,
Jiayu Wang
7   School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China (Ringgold ID: RIN47863)
› Author AffiliationsSupported by: National Natural Science Foundation of China 11502146
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ABSTRACT Background: Augmented reality is a new technology that, when applied to spinal surgery, offers the potential for efficient, safe, and accurate placement of pedicle screws. This study investigated whether augmented reality combined with a guide board improved the safety and accuracy of pedicle screw placement compared to traditional free-hand screw placement. Methods: Four trainers were divided into augmented reality navigation and free-hand groups. Each group consisted of a novice and an experienced spine surgeon. A total of 80 pedicle screws were implanted. First, the AR group reconstructed the 3D model and planned the screw insertion route according to the CT data of L2 lumbar vertebrae. Next, the Microsoft HoloLens™ 2 was used to identify the vertebral model, and the planned virtual path was superimposed on the real cone model. Next, the screw was placed according to the projected trajectory. Finally, Micron Tracker was used to measure the deviation of screws from the preoperatively planned trajectory, and pedicle screws were evaluated using the Gertzbein-Robbins scale. Results: In the augmented reality group, the linear deviation of experienced doctors and novices was 1.59 ± 0.39 mm and 1.73 ± 0.52 mm, and the angle deviation was 2.72 ± 0.61° and 2.87 ± 0.63°, respectively. In the free-hand group, the linear deviation of experienced doctors and novices was 2.88 ± 0.58mm and 5.25 ± 0.62mm, and the angle deviation was 4.41 ± 1.18° and 7.15 ±1.45°, respectively. The screw accuracy rate was 97.5% in the augmented reality navigation group and 77.5% in the free-hand group. Conclusions: Augmented reality navigation improves the accuracy and safety of pedicle screw implantation compared with the traditional free-hand method and can assist inexperienced doctors in completing the surgery.



Publication History

Received: 12 February 2023

Accepted after revision: 24 October 2023

Accepted Manuscript online:
27 October 2023

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