Adolescent Idiopathic Scoliotic Deformity Correction Surgery Assisted by Smart Glasses Can Enhance Correction Outcomes and Accuracy and Also Improve Surgeon Fatigue

Abstract

Augmented reality (AR) is becoming more commonplace and are slowly penetrating the surgical field. With the continuous progression of navigation and visualization techniques, AR has great potential to improve surgical quality and safety. Nevertheless, the impact of AR on surgical outcomes and surgeons' well-being remains poorly studied. This prospective controlled study aims to assess the effect of surgery assisted with AR smart-glasses on adolescent idiopathic scoliosis (AIS) surgical deformity correction outcomes and surgeons' fatigue. AIS patients scheduled for surgical deformity correction were prospectively recruited and assigned to standard or AR-supported surgery, using lightweight AR-smart glasses. Demographic and clinical features were recorded. Pre- and post-surgery spinal features, surgery time, and blood loss were recorded and compared. Finally, participating surgeons were asked to fill in questionnaires (e.g., VAS-fatigue) to compare the impact of AR on their well-being. Our study highlighted enhanced spinal deformity corrections with Cobb angle (-35.7o versus -46.9o), thoracic kyphosis (8.1o versus 11.6o), and vertebral rotation (-9.3o versus -13.8 o) changes favouring AR-supported surgery. Moreover, AR resulted in significantly lower violation rates per patient (7.5% versus 6.6%, p=0.023). Finally, fatigue scores showed consistently a significant reduction in VAS-fatigue (5.7±1.7 versus 3.3±1.2, p<0.001) and other fatigue classifiers for the surgeons following AR-supported surgery. Our controlled study highlighted the enhanced spinal correction rates in AR supported surgeries while also improving surgeons' well-being and fatigue. These results endorse the adaptation of AR techniques to support AIS surgical correction.