1071 Initial Experience Using an Augmented Reality Head-Mounted Display System During Surgical Management of Thoracolumbar Spinal Trauma

Abstract

INTRODUCTION: Advancements in trauma medicine can improve the speed and accuracy of care response with a major impact on downstream operative outcomes. Augmented reality using a head-mounted-display (AR-HMD) is a novel technology that may be applied to spine surgery to provide surgeons with a real-time CT-guided 3-dimensional reconstruction of a patient’s spinal anatomy. METHODS: We retrospectively reviewed trauma patients who underwent pedicle screw placement guided by AR-HMD or robotic-assisted platforms at an academic tertiary care center between January 1, 2021 and December 31, 2022. Demographic, clinical, cost, and perioperative outcome information was analyzed and outcome profiles were compared using a U test. RESULTS: The AR cohort (4 females, 5 males) had a mean age of 66.0 years, BMI of 29.4 kg/m2, Charlson Comorbidity Index (CCI) of 4.11, and Surgical Invasiveness Index (SII) of 8.78. Pedicle screws (77) were placed in the thoracic (51%), lumbar (39%), and sacral spine (10%). Intraoperatively, there was a mean blood loss of 377.78 ml, 0.78 units transfused, 398.33 minutes spent in the operating room, and a 20.00 day LOS. The average 3-month, 6-month, and 12-month ODI scores were 14.25 (n = 8), 15.40 (n = 5), and 12.66 (n = 3). The robotic cohort (5 females, 8 males) had a mean age of 55.6 years, BMI of 27.1 kg/m2, CCI of 3.77, and SII of 14.23. Pedicle screws (128) were placed in the thoracic (59%), lumbar (37%), sacral spine (2%), iliac spine (2%), and pelvis (2%). Intra-operatively, there was a mean blood loss of 431.54 ml, 0.46 units transfused, 330.61 minutes spent in the operating room, and a 10.38 day LOS. The average 3-month, 6-month, and 12-month ODI scores were 22.67 (n = 9), 18.60 (n = 5), and 29.50 (n = 2). CONCLUSIONS: This case series demonstrates the utility of AR-HMD in surgical spinal trauma cases by showing operative outcomes comparable to those observed in robotic-assisted surgery.