What is Augmented Reality in Spine Surgery?

Augmented reality (AR) in spine surgery is a state-of-the-art navigation system that allows your surgeon to view your spine anatomy in 3D through the skin as if your surgeon had “X-ray vision” and assists them to precisely navigate instruments and implants during spinal implant surgery. Contrary to traditional navigation systems, AR allows surgeons to do this while keeping their eyes directly on the patient, rather than looking over at a computer screen.

How Does Augmented Reality in Spine Surgery Work?

Augmented reality utilizes AR glasses or an AR headset to provide your surgeon with “X-ray” vision by combining computer-generated pictures with real-life visuals. Your spine surgeon acquires “X-ray vision” with the headset where he can receive detailed pictures of your unique spine anatomy before even beginning the surgery. Your surgeon will put on a headset with glasses that has a small computer in it that can overlay the pictures of your bones onto their visual field. For example, they see your skin but in the corner of their glasses, they can see the bones as if they are peering through your skin. Not only can these AR glasses show your bones but they can also enable your surgeon to view your bone density, your blood work, your vital signs, and lab results, all while they are performing the surgery.

Indications for Augmented Reality in Spine Surgery

Augmented reality can be utilized to perform various AR-linked surgical procedures to correct deformities in the spine. These include:

Pedicle screw instrumentation
Spinal injection
Vertebroplasty
Tumor resection procedures
Kyphoplasty
Spinal biopsies
Spinal fusion
Spinal deformity correction, such as correction of scoliosis
Treating degenerative spine diseases in the cervical, thoracic, and lumbar regions
Augmented reality-assisted rod bending in spinal surgery

Preparation for Augmented Reality Spine Surgery

Preoperative preparation for augmented reality spine surgery may involve the following steps:

A review of your medical history and a physical examination are performed by your doctor to check for any medical issues that need to be addressed prior to surgery.
You may need to undergo diagnostic tests such as blood work and imaging to help detect any abnormalities that could compromise the safety of the surgery.
You will be asked if you have allergies to medications, anesthesia, or latex.
You should inform your doctor of any medications or supplements that you are taking or any conditions you have such as heart or lung disease.
You may be asked to avoid blood thinning medications such as aspirin for a specific period prior to surgery as they are known to increase your risk of bleeding.
You will be placed on a special diet prior to surgery and laxatives may be used to clean out your bowel.
You may be instructed to shower with an antibacterial soap the night prior to surgery to help lower your risk of infection after surgery.
You should refrain from alcohol or tobacco at least a few days prior to the surgery and several weeks after as it can hinder the healing process.
You should not consume any solids or liquids at least 8 hours prior to surgery.
You are advised to arrange for someone to drive you home after surgery.
A signed informed consent form will be obtained from you after the pros and cons of the surgery have been explained.

Procedure Involved in Augmented Reality Spine Surgery

In general, augmented reality spine surgery will involve the following steps:

You will lie face down on the operating table under the influence of general anesthesia.
Your surgeon will take an intraoperative 3D scan of the operative site, which is fed into an AR headset.
A 3D visualization of the patient’s spine anatomy and 2D navigation data is then superimposed onto the surgical field.
Small surgical incisions are made over the affected vertebrae (cervical, thoracic, or lumbar area).
Segmental tubular retractors and dilators are then inserted through these small incisions to retract muscles and provide access to the spine by creating a working channel for the surgery.
The surgery is performed with special surgical instruments passed through the working channel. Sometimes, surgical microscopes may also be used to magnify the visual field. The AR headset gives your surgeon “X-ray” vision to perform “see-through” surgery.
Surgical correction is followed by spinal instrumentation, which involves accurate placement of fixation devices such as metallic screws, rods, or plates under AR guidance to stabilize the vertebrae and accelerate bone fusion.
Once satisfactory repair is confirmed, the instruments are withdrawn, and the incisions are closed with surgical tapes or sutures and covered with a sterile dressing.

Postoperative Care and Recovery

Postoperative care instructions and recovery after augmented reality spinal surgery may involve the following steps:

You will be transferred to the recovery area where your nurse will closely observe you for any allergic/anesthetic reactions and monitor your vital signs as you recover.
You may experience pain, inflammation, and discomfort in the operated area. Pain and anti-inflammatory medications are provided as needed for comfort.
Application of cold compresses to the treatment area is also recommended to reduce swelling and pain.
Antibiotics are also prescribed as needed to address the risk of surgery-related infection.
Instructions on surgical site care and bathing will be provided to keep the wound clean and dry.
Avoid lifting, bending, or twisting your back for the first few weeks. Do not lift anything heavier than 5 pounds during this period. Refrain from any strenuous activities such as housework, exercise, yard work, or sex for at least a month.
Assistive devices such as a neck collar, corset, or brace may also be recommended to limit bending and assist with the healing of the operated region.
You will be asked to start with an individualized physical therapy regimen after a defined period to help strengthen your spinal muscles and optimize spine function.
You should be able to resume your normal activities in a couple of weeks but may have certain activity restrictions, such as driving.
Complete recovery and return to work vary from patient to patient as it is related to a patient’s age and overall health status and the type of work one does.
A periodic follow-up appointment will be scheduled to monitor your progress.