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Related Experiment Video

Updated: Oct 4, 2025

Pedicle Screw Placement Using an Augmented Reality Head-Mounted Display in a Porcine Model
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Augmented Reality Spine Surgery Navigation: Increasing Pedicle Screw Insertion Accuracy for Both Open and Minimally

Brent Felix1, Seyed Babak Kalatar2, Bradley Moatz3

  • 1Salt Lake Orthopedic Clinic, Salt Lake City, UT.

Spine
|February 8, 2022
PubMed
Summary

Augmented reality (AR) navigation using VisAR demonstrated high accuracy for pedicle screw placement in both open and minimally invasive spine surgery. This technology offers a precise and emerging tool for spinal instrumentation procedures.

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Area of Science:

  • Spine surgery
  • Surgical navigation
  • Augmented reality

Background:

  • Pedicle screw placement accuracy is critical but can be challenging.
  • Surgeon experience and anatomical variations impact screw positioning.
  • Augmented reality (AR) offers potential to improve accuracy and efficiency.

Purpose of the Study:

  • To evaluate the accuracy of pedicle screw placement using VisAR augmented reality guidance.
  • To compare accuracy in open versus minimally invasive spine surgery (MISS).

Main Methods:

  • 124 thoracolumbar pedicle screws were placed in seven cadavers using VisAR.
  • Screws were inserted via open surgery (65) and MISS (59).
  • VisAR (HoloLens 2) provided real-time holographic guidance registered to fiducials.

Main Results:

  • Overall accuracy was 96% (Gertzbein-Robbins grades A and B).
  • Mean angular error was 2.4°.
  • Mean distance error was 1.9 mm.

Conclusions:

  • VisAR augmented reality provides highly accurate pedicle screw navigation.
  • This technology is effective for both open and MISS procedures.
  • Off-the-shelf AR hardware shows promise for spinal surgery.