Augmented Reality-Assisted Percutaneous Pedicle Screw Instrumentation: A Cadaveric Feasibility and Accuracy Study

Chih Chang Chang, Chao Hung Kuo, Hsuan Kan Chang, Tsung Hsi Tu*, Li Yu Fay, Jau Ching Wu, Henrich Cheng, Wen Cheng Huang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Percutaneous pedicle screw instrumentation is the keystone of minimally invasive spine surgery. Percutaneous screw placement demands experience and relies greatly on intra-operative image guidance. This study aims to validate the feasibility and accuracy of augmented-reality (AR)-assisted percutaneous pedicle screw instrumentation. One cadaveric torso was prepared for this study. After a pre-operative computed tomography (CT) scan, the images were transferred to an AR station to generate a 3D hologram. The 3D hologram and navigation images were projected to a pair of goggles with a display screen. With registration, the 3D spine hologram was overlayed onto the cadaver. Bilateral instrumentation from T6 to L5 was performed by two surgeons using AR assistance. A post-operative CT scan was obtained. The Gertzbein–Robbins scale (grade 0–3) was used for accuracy assessment. A total of 24 screws were placed. The overall screw accuracy was 87.5%. There were three major medial breaches that occurred on Rt T6/7/8, which were the most distant screws from the iliac reference. The cause of the three major medial breaches appeared to be related to their distance from the iliac reference. AR-assisted percutaneous pedicle screw instrumentation could improve anatomical visualization, facilitate surgical workflow, and provide an intuitive way of performing surgery.

Original languageEnglish
Article number5261
JournalApplied Sciences (Switzerland)
Volume12
Issue number10
DOIs
StatePublished - 1 May 2022

Keywords

  • 3D hologram
  • augmented reality (AR)
  • minimally invasive spine surgery (MISS)

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