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Augmented Reality Navigated Sacral-Alar-Iliac Screw Insertion.

Cyrill Dennler1, Nico Akhavan Safa1, David Ephraim Bauer1

  • 1Department of Orthopedics, University Hospital Balgrist, University of Zürich, Zürich, Switzerland.

International Journal of Spine Surgery
|April 26, 2021
PubMed
Summary
This summary is machine-generated.

Augmented reality (AR) navigation significantly improved sacral-alar-iliac (SAI) screw placement accuracy in a lab setting. This AR system offers a precise, minimally invasive alternative to traditional freehand (FH) techniques for lumbo-pelvic fixation.

Keywords:
HoloLensaugmented realitylumbo-pelvic fixationmixed realitynavigationsacral-alar-iliac

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Area of Science:

  • Spinal Surgery
  • Medical Technology
  • Surgical Navigation

Background:

  • Sacral-alar-iliac (SAI) screws are vital for lumbo-pelvic fixation but challenging to insert.
  • Current navigation systems are often costly and time-consuming.
  • Augmented reality (AR) offers a potentially more accessible navigation solution.

Purpose of the Study:

  • To evaluate the accuracy and precision of an AR-based navigation system for SAI screw insertion.
  • To compare AR navigation with the freehand (FH) technique in a simulated surgical environment.

Main Methods:

  • Eighty SAI screw trajectories were drilled in a pelvic sawbone model by two surgeons.
  • Procedures were performed either freehand (FH) or using AR navigation.
  • Key metrics included perforation rates, angular accuracy (tSCCIA), and maximal screw length (MSL).

Main Results:

  • AR navigation resulted in significantly lower perforation rates (2.5% vs. 60% for FH, P < .05).
  • AR-guided holes showed improved accuracy for true sagittal cranio-caudal inclination angle (tSCCIA) and maximal screw length (MSL) compared to optimal values (P = .001).

Conclusions:

  • AR navigation enhanced the precision of pilot hole drilling for SAI screws in a laboratory setting.
  • The AR system provides valuable anatomical information and superimposed planning.
  • Further studies are needed to confirm clinical benefits of this AR-based approach.