Augmented Reality-assisted Pedicle Instrumentation: Versatility Across Major Instrumentation Sets.

Abstract

Laboratory investigation with phantom spine models. The aim of this study was to demonstrate the ability of Augmented Reality system to track instruments from different companies without major modifications. Augmented Reality is an emergent technology with applications in industrial, military, gaming, and medical fields. AR applications in Spine surgery are actively being developed. Features of headpiece ergonomics, digital processing power, intuitive interface, and reliable accuracy are being optimized for successful adaptation of technology into the field. System versatility across various instrumentation sets is important for cost-effectiveness and efficiency in application. In this project, five phantom spine models were instrumented L1-S1 with pedicle screws from five major companies. AR assistance was used for all. Each screwdriver was equipped with a generic 3D printed navigation marker for tracking. Every instrumentation set was successfully paired with AR navigation imaging. Sixty pedicle screws were inserted with an average time of 1.6 min/screw. There was an evidence of learning curve with fastest time achieved of 1 min/screw. All five systems had equivocal radiographic outcomes. There were two breached screws (3%). Any currently available instrumentation set can readily pair for tracking with Augmented Reality system. Active tracking of the drivers allowed for improved accuracy making AR system very attractive as an adjunct to the current instrumentation techniques. 3.