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Updated: Nov 11, 2025

Pedicle Screw Placement Using an Augmented Reality Head-Mounted Display in a Porcine Model
Published on: May 24, 2024
Hamid Ghaednia1, Mitchell S Fourman1, Amanda Lans2
1Spine Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA; Orthopaedic Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
This review examines how augmented and virtual reality technologies are currently used in spine surgery, including their roles in surgical planning, navigation, and medical training, while exploring their potential to transform future clinical practice.
Area of Science:
Background:
No prior work had resolved the full scope of immersive visualization tools within spinal procedures. While deep learning advancements continue to reshape medical fields, the specific adoption of digital overlays remains fragmented. Prior research has shown that traditional navigation systems often lack the flexibility provided by modern digital interfaces. That uncertainty drove the need to synthesize existing literature on these emerging platforms. It was already known that hardware costs and integration challenges hinder widespread clinical implementation. However, the specific benefits of these tools for complex interventions like pedicle screw placement require further clarification. This gap motivated a comprehensive assessment of current hardware capabilities. The authors sought to bridge the divide between technological potential and routine surgical practice.
Purpose Of The Study:
The aim of this study was to provide surgeons and researchers with a comprehensive overview of digital visualization systems. The authors sought to clarify the current applications of these tools in spinal procedures. This work addresses the need for a synthesized understanding of existing hardware capabilities. The researchers intended to evaluate the accessibility of these systems in modern clinical environments. By examining current trends, the study highlights the gap between technological innovation and routine surgical use. The authors also aimed to explore the potential for future integration with other advanced medical technologies. This analysis provides a foundation for understanding how these tools might evolve. The study serves as a guide for those navigating the rapidly changing landscape of surgical technology.
Main Methods:
Review approach involved a systematic search of academic databases including PubMed and Google Scholar. The authors identified over 250 initial titles using specific orthopaedic search terms. From this pool, 89 relevant abstracts underwent a rigorous screening process. The team ultimately selected 67 full-text articles for detailed analysis. Reviewers categorized these documents into four distinct thematic groups. A dual-reviewer team conducted the assessment to ensure consistency across all findings. They also performed a comprehensive web search to capture the most recent technological updates. This methodology ensured that the synthesis reflected the current state of the art in the field.
Main Results:
Key findings from the literature indicate that these technologies are increasingly utilized for pedicle screw placement and bone biopsy. The analysis reveals that current applications remain limited despite the clear benefits of low-cost navigation. Researchers identified that these tools effectively support osteotomy planning and percutaneous interventions. The data show that educational platforms are gaining traction for training purposes. The review highlights that hardware flexibility allows for integration with existing surgical technologies. Findings suggest that current systems are primarily used in specialized clinical settings. The authors note that the literature reflects a growing interest in these digital solutions. The evidence confirms that these tools are transitioning from experimental to practical clinical applications.
Conclusions:
The authors propose that immersive digital tools will likely become standard components of spinal care. Synthesis and implications suggest that hardware accessibility remains a primary hurdle for widespread adoption. Future integration with robotics and artificial intelligence may enhance the precision of percutaneous interventions. The researchers note that educational applications currently offer significant value for training surgeons in complex anatomical tasks. Evidence indicates that these systems provide unique advantages over traditional navigation methods. The review highlights that current clinical use is constrained by limited long-term outcome data. Authors suggest that gaming and wearable technologies could further expand the utility of these platforms. The findings underscore a transition toward more integrated and user-friendly surgical environments.
According to the authors, these systems improve navigation accuracy for procedures like pedicle screw placement and cervical foraminotomy. The researchers propose that these tools offer superior flexibility compared to traditional methods by providing real-time visual guidance during complex spinal interventions.
The researchers categorize the literature into four distinct domains: technological development, surgical implementation, educational training, and general orthopedic practice. This classification allows for a structured evaluation of how different hardware platforms serve specific clinical and academic needs.
The authors state that a thorough web search and a dual-reviewer process were necessary to ensure the inclusion of the most current advancements. This rigorous approach minimized selection bias while capturing the rapidly evolving landscape of digital surgical technology.
The researchers propose that these technologies act as a bridge between preoperative planning and intraoperative execution. By integrating with robotic platforms, these systems provide a cohesive workflow that enhances the surgeon's ability to perform precise bone biopsies and osteotomies.
The authors highlight that the current state of the art is measured by the successful application of digital overlays in navigation systems. They suggest that future performance metrics will likely include the seamless integration of wearables and artificial intelligence into the standard surgical workflow.
The researchers propose that the future potential of these tools lies in their synergy with artificial intelligence and robotic surgery. They suggest that these combined technologies will soon evolve into a standard of care for spinal procedures.