Utilization of Augmented Reality Head-Mounted Display for the Surgical Management of Thoracolumbar Spinal Trauma

• Published in: Medicina (Kaunas, Lithuania) Lithuania), 2024-02, Vol.60 (2), p.281
• Main Authors: Kann, Michael Ryan, Ruiz-Cardozo, Miguel A, Brehm, Samuel, Bui, Tim, Joseph, Karan, Barot, Karma, Trevino, Gabriel, Carey-Ewend, Abigail, Singh, Som P, De La Paz, Matthew, Hanafy, Ahmed, Olufawo, Michael, Patel, Rujvee P, Yahanda, Alexander T, Perdomo-Pantoja, Alexander, Jauregui, Julio J, Cadieux, Magalie, Pennicooke, Brenton, Molina, Camilo A
• Format: Article
• Language: English
• Subjects: Accuracy; Aged; Augmented Reality; Back surgery; Body mass index; Emergency medical services; Fluoroscopy - methods; Hospitals; Humans; image-guided surgery; Middle Aged; Patients; Registration; Retrospective Studies; Robotic surgery; Robotics; Software; Spinal Fusion - methods; spine surgery; spine trauma; Surgeons; Surgery, Computer-Assisted - methods; Surgical techniques; Trauma
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60020281

: Augmented reality head-mounted display (AR-HMD) is a novel technology that provides surgeons with a real-time CT-guided 3-dimensional recapitulation of a patient's spinal anatomy. In this case series, we explore the use of AR-HMD alongside more traditional robotic assistance in surgical spine trauma cases to determine their effect on operative costs and perioperative outcomes. : We retrospectively reviewed trauma patients who underwent pedicle screw placement surgery guided by AR-HMD or robotic-assisted platforms at an academic tertiary care center between 1 January 2021 and 31 December 2022. Outcome distributions were compared using the Mann-Whitney U test. : The AR cohort (n = 9) had a mean age of 66 years, BMI of 29.4 kg/m , Charlson Comorbidity Index (CCI) of 4.1, and Surgical Invasiveness Index (SII) of 8.8. In total, 77 pedicle screws were placed in this cohort. Intra-operatively, there was a mean blood loss of 378 mL, 0.78 units transfused, 398 min spent in the operating room, and a 20-day LOS. The robotic cohort (n = 13) had a mean age of 56 years, BMI of 27.1 kg/m , CCI of 3.8, and SII of 14.2. In total, 128 pedicle screws were placed in this cohort. Intra-operatively, there was a mean blood loss of 432 mL, 0.46 units transfused units used, 331 min spent in the operating room, and a 10.4-day LOS. No significant difference was found between the two cohorts in any outcome metrics. : Although the need to address urgent spinal conditions poses a significant challenge to the implementation of innovative technologies in spine surgery, this study represents an initial effort to show that AR-HMD can yield comparable outcomes to traditional robotic surgical techniques. Moreover, it highlights the potential for AR-HMD to be readily integrated into Level 1 trauma centers without requiring extensive modifications or adjustments.