A novel 3D guidance system using augmented reality for percutaneous vertebroplasty: technical note

Area of Science:

• Medical Imaging
• Surgical Navigation
• Augmented Reality

Background:

• Percutaneous vertebroplasty (PVP) requires precise needle placement.
• Traditional methods can lead to inaccuracies in needle trajectory.
• Augmented reality (AR) offers potential for enhanced surgical guidance.

Purpose of the Study:

• To introduce and evaluate a novel AR guidance system, VIPAR (Virtual Protractor with Augmented Reality).
• To assess VIPAR's accuracy in visualizing needle trajectory in 3D space during PVP.
• To compare the accuracy of VIPAR-guided PVP with conventional methods.

Main Methods:

• Development of the VIPAR system using a head-mount display (HMD), tracking camera, and AR software.
• Evaluation using a spine phantom model with 3D CT scanning.
• Clinical assessment in 5 patients undergoing VIPAR-guided PVP for osteoporotic vertebral fractures.

Main Results:

• VIPAR significantly reduced the error of insertion angle (EIA) in both axial (0.96° ± 0.61° vs 4.34° ± 2.36°) and sagittal (0.61° ± 0.70° vs 2.55° ± 1.93°) planes in phantom trials.
• Clinical evaluation showed postoperative EIA of 2.09° ± 1.3° (axial) and 1.98° ± 1.8° (sagittal).
• No pedicle breaches or polymethylmethacrylate leakage were observed in clinical cases.

Conclusions:

• VIPAR successfully assists needle insertion in PVP by providing real-time 3D trajectory visualization.
• AR guidance technology demonstrates potential as a valuable tool in percutaneous spine surgeries.
• VIPAR enhances surgical precision and safety in PVP procedures.