Sign in to use this feature.

Years

Between: -

Subjects

remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline

Journals

Article Types

Countries / Regions

Search Results (51)

Search Parameters:
Keywords = surgical instrument navigation

Order results
Result details
Results per page
Select all
Export citation of selected articles as:
20 pages, 3857 KiB  
Review
Utility of Enabling Technologies in Spinal Deformity Surgery: Optimizing Surgical Planning and Intraoperative Execution to Maximize Patient Outcomes
by Nora C. Kim, Eli Johnson, Christopher DeWald, Nathan Lee and Timothy Y. Wang
J. Clin. Med. 2025, 14(15), 5377; https://doi.org/10.3390/jcm14155377 - 30 Jul 2025
Viewed by 229
Abstract
The management of adult spinal deformity (ASD) has evolved dramatically over the past century, transitioning from external bracing and in situ fusion to complex, technology-driven surgical interventions. This review traces the historical development of spinal deformity correction and highlights contemporary enabling technologies that [...] Read more.
The management of adult spinal deformity (ASD) has evolved dramatically over the past century, transitioning from external bracing and in situ fusion to complex, technology-driven surgical interventions. This review traces the historical development of spinal deformity correction and highlights contemporary enabling technologies that are redefining the surgical landscape. Advances in stereoradiographic imaging now allow for precise, low-dose three-dimensional assessment of spinopelvic parameters and segmental bone density, facilitating individualized surgical planning. Robotic assistance and intraoperative navigation improve the accuracy and safety of instrumentation, while patient-specific rods and interbody implants enhance biomechanical conformity and alignment precision. Machine learning and predictive modeling tools have emerged as valuable adjuncts for risk stratification, surgical planning, and outcome forecasting. Minimally invasive deformity correction strategies, including anterior column realignment and circumferential minimally invasive surgery (cMIS), have demonstrated equivalent clinical and radiographic outcomes to traditional open surgery with reduced perioperative morbidity in select patients. Despite these advancements, complications such as proximal junctional kyphosis and failure remain prevalent. Adjunctive strategies—including ligamentous tethering, modified proximal fixation, and vertebral cement augmentation—offer promising preventive potential. Collectively, these innovations signal a paradigm shift toward precision spine surgery, characterized by data-informed decision-making, individualized construct design, and improved patient-centered outcomes in spinal deformity care. Full article
(This article belongs to the Special Issue Clinical New Insights into Management of Scoliosis)
Show Figures

Figure 1

19 pages, 3117 KiB  
Article
Feasibility and Accuracy of a Dual-Function AR-Guided System for PSI Positioning and Osteotomy Execution in Pelvic Tumour Surgery: A Cadaveric Study
by Tanya Fernández-Fernández, Javier Orozco-Martínez, Carla de Gregorio-Bermejo, Elena Aguilera-Jiménez, Amaia Iribar-Zabala, Lydia Mediavilla-Santos, Javier Pascau, Mónica García-Sevilla, Rubén Pérez-Mañanes and José Antonio Calvo-Haro
Bioengineering 2025, 12(8), 810; https://doi.org/10.3390/bioengineering12080810 - 28 Jul 2025
Viewed by 257
Abstract
Objectives: Pelvic tumor resections demand high surgical precision to ensure clear margins while preserving function. Although patient-specific instruments (PSIs) improve osteotomy accuracy, positioning errors remain a limitation. This study evaluates the feasibility, accuracy, and usability of a novel dual-function augmented reality (AR) [...] Read more.
Objectives: Pelvic tumor resections demand high surgical precision to ensure clear margins while preserving function. Although patient-specific instruments (PSIs) improve osteotomy accuracy, positioning errors remain a limitation. This study evaluates the feasibility, accuracy, and usability of a novel dual-function augmented reality (AR) system for intraoperative guidance in PSI positioning and osteotomy execution using a head-mounted display (HMD). The system provides dual-function support by assisting both PSI placement and osteotomy execution. Methods: Ten fresh-frozen cadaveric hemipelves underwent AR-assisted internal hemipelvectomy, using customized 3D-printed PSIs and a new in-house AR software integrated into an HMD. Angular and translational deviations between planned and executed osteotomies were measured using postoperative CT analysis. Absolute angular errors were computed from plane normals; translational deviation was assessed as maximum error at the osteotomy corner point in both sagittal (pitch) and coronal (roll) planes. A Wilcoxon signed-rank test and Bland–Altman plots were used to assess intra-workflow cumulative error. Results: The mean absolute angular deviation was 5.11 ± 1.43°, with 86.66% of osteotomies within acceptable thresholds. Maximum pitch and roll deviations were 4.53 ± 1.32 mm and 2.79 ± 0.72 mm, respectively, with 93.33% and 100% of osteotomies meeting translational accuracy criteria. Wilcoxon analysis showed significantly lower angular error when comparing final executed planes to intermediate AR-displayed planes (p < 0.05), supporting improved PSI positioning accuracy with AR guidance. Surgeons rated the system highly (mean satisfaction ≥ 4.0) for usability and clinical utility. Conclusions: This cadaveric study confirms the feasibility and precision of an HMD-based AR system for PSI-guided pelvic osteotomies. The system demonstrated strong accuracy and high surgeon acceptance, highlighting its potential for clinical adoption in complex oncologic procedures. Full article
Show Figures

Figure 1

16 pages, 588 KiB  
Study Protocol
The Effects of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunt on Neuropsychological and Motor Performance in Patients with Idiopathic Normal Pressure Hydrocephalus—ENVENTOR-iNPH: Study Protocol
by Gianluca Scalia, Nicola Alberio, Pietro Trombatore, Mariangela Panebianco, Grazia Razza, Gianluca Galvano, Giovanni Federico Nicoletti and Francesca Graziano
Brain Sci. 2025, 15(5), 508; https://doi.org/10.3390/brainsci15050508 - 16 May 2025
Viewed by 1178
Abstract
Background: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive neurological disorder characterized by cognitive decline, gait disturbances, and urinary incontinence. Surgical interventions such as ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) are the primary treatment options. While VPS is the standard of [...] Read more.
Background: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive neurological disorder characterized by cognitive decline, gait disturbances, and urinary incontinence. Surgical interventions such as ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) are the primary treatment options. While VPS is the standard of care, ETV offers a minimally invasive alternative with potentially fewer complications. However, comparative evidence regarding their impact on cognitive, motor, and structural outcomes remains limited. This study, titled ENVENTOR-iNPH (endoscopic ventriculostomy versus shunt on neuropsychological and motor performance in patients with iNPH), aims to address this gap through a rigorously designed comparative protocol. Methods: This protocol is designed as a multicenter, randomized, controlled trial (ENVENTOR-iNPH) to compare the effects of ETV and VPS in patients diagnosed with iNPH. The study will enroll 100 patients aged 60 years or older, randomly assigned to undergo ETV (n = 50) or VPS (n = 50). Preoperative and postoperative evaluations will include comprehensive cognitive and motor assessments, standardized quality-of-life instruments, and advanced neuroimaging techniques such as MRI with flowmetry and diffusion tensor imaging (DTI). Functional outcomes will also be evaluated using navigated transcranial magnetic stimulation (nTMS) and wearable motion analysis systems. The objective of this study is to compare the efficacy and safety of ETV versus VPS in restoring cognitive and motor performance in patients with iNPH. Results: Primary outcomes include cognitive and motor function improvements. Secondary endpoints are surgical complications, hospital stay duration, and changes in quality of life. Neuroimaging will assess changes in white matter integrity and cerebrospinal fluid dynamics, while nTMS will provide insights into neuroplasticity and motor pathway recovery. ETV is hypothesized to demonstrate clinical outcomes comparable or superior to VPS, particularly in terms of complication reduction and hospital recovery metrics. Conclusions: The ENVENTOR-iNPH protocol establishes the framework for a comprehensive, multicenter study comparing ETV and VPS in iNPH patients. The findings from this initial study will inform the design of larger-scale multicenter trials, guide clinical decision making, and potentially position ETV as a preferred treatment option for eligible patients. Full article
(This article belongs to the Special Issue Editorial Board Collection Series: Insight into Neurosurgery)
Show Figures

Figure 1

22 pages, 589 KiB  
Systematic Review
Current Trends and Future Directions in Lumbar Spine Surgery: A Review of Emerging Techniques and Evolving Management Paradigms
by Gianluca Galieri, Vittorio Orlando, Roberto Altieri, Manlio Barbarisi, Alessandro Olivi, Giovanni Sabatino and Giuseppe La Rocca
J. Clin. Med. 2025, 14(10), 3390; https://doi.org/10.3390/jcm14103390 - 13 May 2025
Cited by 1 | Viewed by 1540
Abstract
Background/Objectives: Lumbar spine surgery has undergone significant technological transformation in recent years, driven by the goals of minimizing invasiveness, improving precision, and enhancing clinical outcomes. Emerging tools—including robotics, augmented reality, computer-assisted navigation, and artificial intelligence—have complemented the evolution of minimally invasive surgical [...] Read more.
Background/Objectives: Lumbar spine surgery has undergone significant technological transformation in recent years, driven by the goals of minimizing invasiveness, improving precision, and enhancing clinical outcomes. Emerging tools—including robotics, augmented reality, computer-assisted navigation, and artificial intelligence—have complemented the evolution of minimally invasive surgical (MIS) approaches, such as endoscopic and lateral interbody fusions. Methods: This systematic review evaluates the literature from February 2020 to February 2025 on technological and procedural innovations in LSS. Eligible studies focused on degenerative lumbar pathologies, advanced surgical technologies, and reported clinical or perioperative outcomes. Randomized controlled trials, comparative studies, meta-analyses, and large case series were included. Results: A total of 32 studies met the inclusion criteria. Robotic-assisted surgery demonstrated high accuracy in pedicle screw placement (~92–94%) and reduced intraoperative blood loss and radiation exposure, although long-term clinical outcomes were comparable to conventional techniques. Intraoperative navigation improved instrumentation precision, while AR enhanced ergonomic workflow and reduced surgeon distraction. AI tools showed promise in surgical planning, guidance, and outcome prediction but lacked definitive evidence of clinical superiority. MIS techniques—including endoscopic discectomy and MIS-TLIF—offered reduced blood loss, shorter hospital stays, and faster recovery, with equivalent pain relief, fusion rates, and complication profiles compared to open procedures. Lateral and oblique approaches (XLIF/OLIF) further optimized alignment and indirect decompression, with favorable perioperative metrics. Conclusions: Recent innovations in lumbar spine surgery have enhanced technical precision and perioperative efficiency without compromising patient outcomes. While short-term benefits are clear, long-term clinical advantages and cost-effectiveness require further investigation. Integration of robotics, navigation, AI, and MIS into spine surgery reflects an ongoing shift toward personalized, data-driven, and less invasive care. Full article
(This article belongs to the Special Issue New Perspectives in Lumbar Spine Surgery: Treatment and Management)
Show Figures

Figure 1

19 pages, 12128 KiB  
Article
Marker-Less Navigation System for Anterior Cruciate Ligament Reconstruction with 3D Femoral Analysis and Arthroscopic Guidance
by Shuo Wang, Weili Shi, Shuai Yang, Jiahao Cui and Qinwei Guo
Bioengineering 2025, 12(5), 464; https://doi.org/10.3390/bioengineering12050464 - 27 Apr 2025
Viewed by 535
Abstract
Accurate femoral tunnel positioning is crucial for successful anterior cruciate ligament reconstruction (ACLR), yet traditional arthroscopic techniques face significant challenges in spatial orientation and precise anatomical localization. This study presents a novel marker-less computer-assisted navigation system that integrates three-dimensional femoral modeling with real-time [...] Read more.
Accurate femoral tunnel positioning is crucial for successful anterior cruciate ligament reconstruction (ACLR), yet traditional arthroscopic techniques face significant challenges in spatial orientation and precise anatomical localization. This study presents a novel marker-less computer-assisted navigation system that integrates three-dimensional femoral modeling with real-time arthroscopic guidance. The system employs advanced image processing techniques for accurate condyle segmentation and implements the Bernard and Hertel (BH) grid system for standardized positioning. A curvature-based feature extraction approach precisely identifies the capsular line reference (CLR) on the lateral condyle surface, forming the foundation for establishing the BH reference grid. The system’s two-stage registration framework, combining SIFT-ICP algorithms, achieves accurate alignment between preoperative models and arthroscopic views. Validation results from expert surgeons demonstrated high precision, with 71.5% of test groups achieving acceptable or excellent performance standards (mean deviation distances: 1.12–1.86 mm). Unlike existing navigation solutions, our system maintains standard surgical workflow without requiring additional surgical instruments or markers, offering an efficient and minimally invasive approach to enhance ACLR precision. This innovation bridges the gap between preoperative planning and intraoperative execution, potentially improving surgical outcomes through standardized tunnel positioning. Full article
(This article belongs to the Special Issue Advances in Medical 3D Vision: Voxels and Beyond)
Show Figures

Figure 1

12 pages, 3749 KiB  
Article
3D CT-Based Preoperative Planning and Intraoperative Navigation in Reverse Shoulder Arthroplasty: Early Clinical Outcomes
by Elisa Troiano, Azzurra Masini, Giovanni Battista Colasanti, Caterina Drago, Stefano Giannotti and Nicola Mondanelli
Medicina 2025, 61(4), 749; https://doi.org/10.3390/medicina61040749 - 18 Apr 2025
Viewed by 805
Abstract
Background and Objectives: Reverse shoulder arthroplasty (RSA) is an effective surgical procedure for treating end-stage rotator cuff arthropathy, but it is burdened by a relatively high complication rate, mainly due to glenoid component failure. Preoperative planning and intraoperative navigation based on three-dimensional [...] Read more.
Background and Objectives: Reverse shoulder arthroplasty (RSA) is an effective surgical procedure for treating end-stage rotator cuff arthropathy, but it is burdened by a relatively high complication rate, mainly due to glenoid component failure. Preoperative planning and intraoperative navigation based on three-dimensional computed tomography (3D CT) scans have proven to be efficient tools for improving the accuracy and stability of the glenoid component. However, this technology is still developing, and there is currently little available research on the subject, especially where clinical outcomes are concerned. The purpose of this retrospective observational study is to report the radiographic and clinical outcomes of a consecutive series of patients that underwent RSA with the use of these new technologies, compared to a standard procedure. Materials and Methods: A consecutive series of 80 patients underwent RSA for shoulder osteoarthritis by a single surgeon at a single institution with a mean follow-up of 41.9 ± 23.6 months (range 24–108) and were divided into two groups according to the surgical technique employed (conventional or navigated surgery), and they were clinically and radiographically assessed at 1, 3, 6, and 12 months after surgery, and then annually. Results: No statistically significant differences were highlighted among the two groups according to complication rate, radiographical glenoid notching, and clinical outcomes. However, a statistically significant difference was observed in screw number and length and surgical time. In the navigated group, fewer screws with longer lengths had been implanted, with a longer surgical time. Conclusions: The use of 3D CT-based preoperative planning and intraoperative navigation is a safe procedure and produces comparable results with respect to standard instrumentation, without an increased risk of complications. It allowed to achieve higher stability of the implant, saving bone stock due to the use of fewer and longer screws than in a conventional procedure. This could also eventually result in a higher longevity of the implant itself. Full article
(This article belongs to the Special Issue Cutting-Edge Topics in Joint Arthroplasties)
Show Figures

Figure 1

10 pages, 3278 KiB  
Article
Augmented Reality in Scoliosis Correction Surgery: Efficiency and Accuracy in Pedicle Screw Instrumentation
by Chia-Ning Chang, Chi-Ruei Li, Sian-Siang Liao, Chiung-Chyi Shen, Kai-Yuan Chen, Chung-Hsin Lee and Meng-Yin Yang
Medicina 2025, 61(4), 576; https://doi.org/10.3390/medicina61040576 - 24 Mar 2025
Cited by 1 | Viewed by 666
Abstract
Background and Objectives: Recent advancements in spinal navigation methodologies, particularly augmented reality (AR) techniques, have significantly enhanced the precision of spinal instrumentation procedures. This study aimed to evaluate the efficacy of AR-assisted navigation in spinal instrumentation surgery for thoracolumbar scoliosis. Materials and [...] Read more.
Background and Objectives: Recent advancements in spinal navigation methodologies, particularly augmented reality (AR) techniques, have significantly enhanced the precision of spinal instrumentation procedures. This study aimed to evaluate the efficacy of AR-assisted navigation in spinal instrumentation surgery for thoracolumbar scoliosis. Materials and Methods: This retrospective observational study included 10 patients with thoracolumbar scoliosis who met specific inclusion criteria and were recruited at a single medical center. Two neurosurgeons and one neuroradiologist used the Gertzbein–Robbins scale (GRS) for radiological evaluation. Preoperative and postoperative Cobb angles were measured to assess the correction of scoliosis. Overall, 257 screws were placed using the AR-assisted navigation system during thoracic and lumbar spinal deformity surgeries. Results: Among the 257 screws, 197 were placed in the thoracic spine and 60 in the lumbar spine, achieving an overall instrumentation accuracy of 98%. The preoperative Cobb angle of 69.5 ± 22.2° significantly improved to 10.1 ± 4.1° postoperatively. Regarding first-attempt screw placement accuracy, 97.4% of the screws in the thoracic spine (graded as GRS A or B) and 100% in the lumbar spine were placed with precision. Five grade C thoracic screws were identified, one of which required re-instrumentation. Conclusions: The AR navigation technique substantially improved the precision of spinal deformity surgery, with a high screw placement accuracy rate and significant scoliosis correction. The benefits of reduced attention diversion and an intuitive surgical experience suggest that AR technology could significantly improve spinal surgery practices and training programs, indicating potential for broader applicability in the future. Full article
(This article belongs to the Special Issue New Frontiers in Spine Surgery and Spine Disorders)
Show Figures

Figure 1

17 pages, 12017 KiB  
Article
Dimensionality Reduction and Electrode Arrangement Optimization for an Electric Field Source Seeking Surgical Navigation Method
by Yuxin Fang, Fan Yang, Wei He, Xing Li and Xinheng Li
Sensors 2025, 25(5), 1378; https://doi.org/10.3390/s25051378 - 24 Feb 2025
Viewed by 516
Abstract
This study proposes a Dimensionality Reduction Electric Field Source Seeking (EFSS) method for real-time, high-precision navigation in intracranial puncture surgeries. The method integrates internal localization electrodes and external potential measurement electrodes to minimize surgical trauma while ensuring the accurate localization and guidance of [...] Read more.
This study proposes a Dimensionality Reduction Electric Field Source Seeking (EFSS) method for real-time, high-precision navigation in intracranial puncture surgeries. The method integrates internal localization electrodes and external potential measurement electrodes to minimize surgical trauma while ensuring the accurate localization and guidance of surgical instruments. To optimize the electrode arrangement, two evaluation metrics—Mean Response Coefficient (MRC) and MRC-mean—were introduced. The simulation results demonstrated the effectiveness of these metrics, with the optimal arrangement achieving an average localization error below 2 mm and a 56% reduction in error after optimization. Experimental validation was conducted using a brain model with conductivity properties similar to those of human tissue. Localization experiments confirmed the robustness and accuracy of the EFSS method, with all results showing consistent repeatability and monotonic trends in performance across different electrode configurations. This study highlights the potential of the dimensionality reduction EFSS method as a novel and effective approach for navigation in minimally invasive intracranial surgeries. Full article
(This article belongs to the Section Biomedical Sensors)
Show Figures

Figure 1

13 pages, 1336 KiB  
Article
Guided Personalized Surgery (GPS) in Posterostabilized Total Knee Replacement: A Radiological Study
by Ana de Andrés-Torán, Norma G. Padilla-Eguiluz, Pablo Hernández-Esteban and Enrique Gómez-Barrena
J. Clin. Med. 2025, 14(2), 429; https://doi.org/10.3390/jcm14020429 - 10 Jan 2025
Viewed by 1122
Abstract
Background: Surgical accuracy in total knee replacement (TKR) may vary with the surgeon, the patient preoperative deformity, and the guiding system to perform the procedure. Navigation systems attempt to increase the intraoperative information the surgeon requires to make the appropriate decisions, sometimes [...] Read more.
Background: Surgical accuracy in total knee replacement (TKR) may vary with the surgeon, the patient preoperative deformity, and the guiding system to perform the procedure. Navigation systems attempt to increase the intraoperative information the surgeon requires to make the appropriate decisions, sometimes associating cumbersome procedures and unclear effectiveness to place the implant more precisely than conventional instruments. Methods: We conducted a retrospective case-control study with prospective data collection of radiographic measurements (alignment, joint line and patellar height) in a sample of 100 consecutive patients receiving TKR Optetrak Logic PS, either with standard surgical technique with Trulion Instrumentation (n = 59) or with the Guided Personalized Surgery (GPS) system (n = 41). Results: The GPS group improved the alignment of the mechanical Lateral Distal Femoral Angle (mLDFA) in 1.6° compared to the control (p = 0.003), but not evident in the mechanical Medial Proximal Tibial Angle (mMPTA) (p = 0.132). The GPS system achieved a normal patellar height in 98% of cases, according to the Blackburne–Peel Index (BP), compared to 71% in the control group (p = 0.002). This was obtained in the femoral side, as measured in the Epicondylar Ratio (ER) (p = 0.004). A lower dispersion of postoperative measurements was observed in the GPS group in comparison with the control, being statistically significant in mMPTA (p = 0.000), CD-Index (p = 0.011), IS-Index (p = 0.002), mIS-Index (p = 0.008), BP-Index (p = 0.011), and ER (p = 0.004). Conclusions: Better post-surgical restoration of joint line and patellar height is observed in surgeries performed with the GPS system, as well as a tendency to more accurate mechanical alignment and lower inter-patient variability, suggesting higher reproducibility. Full article
(This article belongs to the Section Orthopedics)
Show Figures

Figure 1

12 pages, 2105 KiB  
Article
An Automated Marker-Less Registration Approach Using Neural Radiance Fields for Potential Use in Mixed Reality-Based Computer-Aided Surgical Navigation of Paranasal Sinus
by Suhyeon Kim, Hyeonji Kim and Younhyun Jung
Computers 2025, 14(1), 5; https://doi.org/10.3390/computers14010005 - 27 Dec 2024
Viewed by 904
Abstract
Paranasal sinus surgery, a common treatment for chronic rhinosinusitis, requires exceptional precision due to the proximity of critical anatomical structures. To ensure accurate instrument control and clear visualization of the surgical site, surgeons utilize computer-aided surgical navigation (CSN). A key component of CSN [...] Read more.
Paranasal sinus surgery, a common treatment for chronic rhinosinusitis, requires exceptional precision due to the proximity of critical anatomical structures. To ensure accurate instrument control and clear visualization of the surgical site, surgeons utilize computer-aided surgical navigation (CSN). A key component of CSN is the registration process, which is traditionally reliant on manual or marker-based techniques. However, there is a growing shift toward marker-less registration methods. In previous work, we investigated a mesh-based registration approach using a Mixed Reality Head-Mounted Display (MR-HMD), specifically the Microsoft HoloLens 2. However, this method faced limitations, including depth holes and invalid values. These issues stemmed from the device’s low-resolution camera specifications and the 3D projection steps required to upscale RGB camera spaces. In this study, we propose a novel automated marker-less registration method leveraging Neural Radiance Field (NeRF) technology with an MR-HMD. To address insufficient depth information in the previous approach, we utilize rendered-depth images generated by the trained NeRF model. We evaluated our method against two other techniques, including prior mesh-based registration, using a facial phantom and three participants. The results demonstrate our proposed method achieves at least a 0.873 mm (12%) improvement in registration accuracy compared to others. Full article
Show Figures

Figure 1

11 pages, 277 KiB  
Review
Augmenting Reality in Spinal Surgery: A Narrative Review of Augmented Reality Applications in Pedicle Screw Instrumentation
by Sheng-Xian Xiao, Wen-Tien Wu, Tzai-Chiu Yu, Ing-Ho Chen and Kuang-Ting Yeh
Medicina 2024, 60(9), 1485; https://doi.org/10.3390/medicina60091485 - 12 Sep 2024
Cited by 9 | Viewed by 1992
Abstract
Background and Objectives: The advent of augmented reality (AR) in spinal surgery represents a key technological evolution, enhancing precision and safety in procedures such as pedicle screw instrumentation. This review assesses the current applications, benefits, and challenges of AR technology in spinal [...] Read more.
Background and Objectives: The advent of augmented reality (AR) in spinal surgery represents a key technological evolution, enhancing precision and safety in procedures such as pedicle screw instrumentation. This review assesses the current applications, benefits, and challenges of AR technology in spinal surgery, focusing on its effects on surgical accuracy and patient outcomes. Materials and Methods: A comprehensive review of the literature published between January 2023 and December 2024 was conducted, focusing on AR and navigational technologies in spinal surgery. Key outcomes such as accuracy, efficiency, and complications were emphasized. Results: Thirteen studies were included, highlighting substantial improvements in surgical accuracy, efficiency, and safety with AR and navigational systems. AR technology was found to significantly reduce the learning curve for spinal surgeons, improve procedural efficiency, and potentially reduce surgical complications. The challenges identified include high system costs, the complexity of training requirements, the integration with existing workflows, and limited clinical evidence. Conclusions: AR technology holds promise for advancements in spinal surgery, particularly in improving the accuracy and safety of pedicle screw instrumentation. Despite existing challenges such as cost, training needs, and regulatory hurdles, AR has the potential to transform spinal surgical practices. Ongoing research, technological refinements, and the development of implementation strategies are essential to fully leverage AR’s capabilities in enhancing patient care. Full article
(This article belongs to the Section Surgery)
16 pages, 22963 KiB  
Case Report
Perioperative Benefits of a 3D Printed Spine Biomodel in the Setting of Congenital Scoliosis Surgery
by Dean C. Perfetti, Stanley Kisinde, Theodore A. Belanger and Isador H. Lieberman
Surg. Tech. Dev. 2024, 13(3), 278-293; https://doi.org/10.3390/std13030021 - 9 Aug 2024
Viewed by 1481
Abstract
The spine community is continuously adding to its armamentarium of intraoperative techniques for visualization and instrumentation of the spine. Recently, three-dimensional printed spine models were introduced for use in preoperative planning, surgical simulation, and intraoperative guidance. We present a 14-year old African male [...] Read more.
The spine community is continuously adding to its armamentarium of intraoperative techniques for visualization and instrumentation of the spine. Recently, three-dimensional printed spine models were introduced for use in preoperative planning, surgical simulation, and intraoperative guidance. We present a 14-year old African male with congenital kyphoscoliosis, small stature, an obvious gibbus deformity and coronal imbalance, who underwent a three-staged posterior surgical correction procedure, during which a 3D-printed spine biomodel was utilized for better appreciation of his complex spinal deformity patho-anatomy. During the first stage of the procedure, he developed diminished lower extremity motor strength bilaterally and bowel/bladder control, but, following his third stage procedure and with focused rehabilitation efforts, he has regained full control of his bowel and bladder function, and is able to ambulate and perform activities of daily living independently, albeit still requiring intermittent walking support with a single forearm crutch due to residual left leg weakness. The 3D spine biomodel functioned successfully as a valuable tool and surrogate anatomic blueprint for the surgeons, enabling adequate appreciation of the complex bony anatomy which could not be easily resolved on the conventionally available imaging modalities, intraoperative navigation or robotic platform. Theoretically, up to $2900 USD in savings, translated from the mean estimated time saved per procedure with the use 3D-printed spine models has been proposed in some studies. Therefore, 3D-printed spine models have utility in complex spinal deformity correction surgery. Full article
Show Figures

Figure 1

12 pages, 7510 KiB  
Article
Unlocking Precision in Spinal Surgery: Evaluating the Impact of Neuronavigation Systems
by Mehmet Yigit Akgun, Mete Manici, Ozkan Ates, Melis Gokdemir, Caner Gunerbuyuk, Mehmet Ali Tepebasili, Oguz Baran, Turgut Akgul, Tunc Oktenoglu, Mehdi Sasani and Ali Fahir Ozer
Diagnostics 2024, 14(16), 1712; https://doi.org/10.3390/diagnostics14161712 - 7 Aug 2024
Cited by 1 | Viewed by 1437
Abstract
Objective: In spine surgery, ensuring the safety of vital structures is crucial, and various instruments contribute to the surgeon’s confidence. This study aims to present outcomes from spinal cases operated on using the freehand technique and neuronavigation with an O-arm in our clinic. [...] Read more.
Objective: In spine surgery, ensuring the safety of vital structures is crucial, and various instruments contribute to the surgeon’s confidence. This study aims to present outcomes from spinal cases operated on using the freehand technique and neuronavigation with an O-arm in our clinic. Additionally, we investigate the impact of surgical experience on outcomes by comparing early and late cases operated on with neuronavigation. Method: We conducted a retrospective analysis of spinal patients operated on with the freehand technique and neuronavigation in our clinic between 2019 and 2020, with a minimum follow-up of 2 years. Cases operated on with neuronavigation using the O-arm were categorized into early and late groups. Results: This study included 193 patients, with 110 undergoing the freehand technique and 83 operated on utilizing O-arm navigation. The first 40 cases with neuronavigation formed the early group, and the subsequent 43 cases comprised the late group. The mean clinical follow-up was 29.7 months. In the O-arm/navigation group, 796 (99%) of 805 pedicle screws were in an acceptable position, while the freehand group had 999 (89.5%) of 1117 pedicle screws without damage. This rate was 98% in the early neuronavigation group and 99.5% in the late neuronavigation group. Conclusions: The use of O-arm/navigation facilitates overcoming anatomical difficulties, leading to significant reductions in screw malposition and complication rates. Furthermore, increased experience correlates with decreased surgical failure rates. Full article
Show Figures

Figure 1

12 pages, 255 KiB  
Review
Robotic Total Knee Arthroplasty: An Update
by Gennaro Pipino, Alessio Giai Via, Marco Ratano, Marco Spoliti, Riccardo Maria Lanzetti and Francesco Oliva
J. Pers. Med. 2024, 14(6), 589; https://doi.org/10.3390/jpm14060589 - 30 May 2024
Cited by 2 | Viewed by 2426
Abstract
Total knee arthroplasty (TKA) is a gold standard surgical procedure to improve pain and restore function in patients affected by moderate-to-severe severe gonarthrosis refractory to conservative treatments. Indeed, millions of these procedures are conducted yearly worldwide, with their number expected to increase in [...] Read more.
Total knee arthroplasty (TKA) is a gold standard surgical procedure to improve pain and restore function in patients affected by moderate-to-severe severe gonarthrosis refractory to conservative treatments. Indeed, millions of these procedures are conducted yearly worldwide, with their number expected to increase in an ageing and more demanding population. Despite the progress that has been made in optimizing surgical techniques, prosthetic designs, and durability, up to 20% of patients are dissatisfied by the procedure or still report knee pain. From this perspective, the introduction of robotic TKA (R-TKA) in the late 1990s represented a valuable instrument in performing more accurate bone cuts and improving clinical outcomes. On the other hand, prolonged operative time, increased complications, and high costs of the devices slow down the diffusion of R-TKA. The advent of newer technological devices, including those using navigation systems, has made robotic surgery in the operatory room more common since the last decade. At present, many different robots are available, representing promising solutions to avoid persistent knee pain after TKA. We hereby describe their functionality, analyze potential benefits, and hint at future perspectives in this promising field. Full article
(This article belongs to the Section Methodology, Drug and Device Discovery)
8 pages, 13835 KiB  
Case Report
Augmented Reality in Spine Surgery: A Case Study of Atlantoaxial Instrumentation in Os Odontoideum
by Chi-Ruei Li, Yu-Jui Chang, Mao-Shih Lin and Hsi-Kai Tsou
Medicina 2024, 60(6), 874; https://doi.org/10.3390/medicina60060874 - 27 May 2024
Cited by 1 | Viewed by 3127
Abstract
Despite advancement in surgical innovation, C1-C2 fixation remains challenging due to risks of screw malposition and vertebral artery (VA) injuries. Traditional image-based navigation, while useful, often demands that surgeons frequently shift their attention to external monitors, potentially causing distractions. In this article, we [...] Read more.
Despite advancement in surgical innovation, C1-C2 fixation remains challenging due to risks of screw malposition and vertebral artery (VA) injuries. Traditional image-based navigation, while useful, often demands that surgeons frequently shift their attention to external monitors, potentially causing distractions. In this article, we introduce a microscope-based augmented reality (AR) navigation system that projects both anatomical information and real-time navigation images directly onto the surgical field. In the present case report, we discuss a 37-year-old female who suffered from os odontoideum with C1-C2 subluxation. Employing AR-assisted navigation, the patient underwent the successful posterior instrumentation of C1-C2. The integrated AR system offers direct visualization, potentially minimizing surgical distractions. In our opinion, as AR technology advances, its adoption in surgical practices and education is anticipated to expand. Full article
(This article belongs to the Special Issue Clinical Application of Augmented Reality (AR) in Neurosurgery)
Show Figures

Figure 1

Back to TopTop