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International Journal of Computer Assisted Radiology and Surgery

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22.06.2018 | Original Article

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

verfasst von: Jacob T. Gibby, Samuel A. Swenson, Steve Cvetko, Raj Rao, Ramin Javan

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 3/2019

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Abstract

Purpose

Augmented reality has potential to enhance surgical navigation and visualization. We determined whether head-mounted display augmented reality (HMD-AR) with superimposed computed tomography (CT) data could allow the wearer to percutaneously guide pedicle screw placement in an opaque lumbar model with no real-time fluoroscopic guidance.

Methods

CT imaging was obtained of a phantom composed of L1–L3 Sawbones vertebrae in opaque silicone. Preprocedural planning was performed by creating virtual trajectories of appropriate angle and depth for ideal approach into the pedicle, and these data were integrated into the Microsoft HoloLens using the Novarad OpenSight application allowing the user to view the virtual trajectory guides and CT images superimposed on the phantom in two and three dimensions. Spinal needles were inserted following the virtual trajectories to the point of contact with bone. Repeat CT revealed actual needle trajectory, allowing comparison with the ideal preprocedural paths.

Results

Registration of AR to phantom showed a roughly circular deviation with maximum average radius of 2.5 mm. Users took an average of 200 s to place a needle. Extrapolation of needle trajectory into the pedicle showed that of 36 needles placed, 35 (97%) would have remained within the pedicles. Needles placed approximated a mean distance of 4.69 mm in the mediolateral direction and 4.48 mm in the craniocaudal direction from pedicle bone edge.

Conclusion

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.

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Titel: Head-mounted display augmented reality to guide pedicle screw placement utilizing computed tomography
verfasst von: Jacob T. Gibby
Samuel A. Swenson
Steve Cvetko
Raj Rao
Ramin Javan
Publikationsdatum: 22.06.2018
Verlag: Springer International Publishing
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 3/2019
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-018-1814-7

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

Abstract

Purpose

Methods

Results

Conclusion

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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