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Usability Evaluation of Augmented Reality: A Neuro-Information-Systems Study
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How different augmented reality visualizations for drilling affect trajectory deviation, visual attention, and user

Julian Wolf1, Dietmar Luchmann2, Quentin Lohmeyer3

  • 1PDZ, Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland. wolfju@ethz.ch.

International Journal of Computer Assisted Radiology and Surgery
|February 22, 2023
PubMed
Summary
This summary is machine-generated.

Augmented reality (AR) visualizations for pedicle screw placement significantly improve surgical accuracy. Abstract or 3D anatomical AR displays, especially those peripherally anchored, enhance surgeon performance and user experience.

Keywords:
Cognitive loadEye trackingMixed realitySurgical navigationUsability

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Area of Science:

  • Medical Technology
  • Surgical Navigation
  • Augmented Reality

Background:

  • Augmented reality (AR) head-mounted displays (HMDs) show high accuracy for pedicle screw placement in spinal fusion.
  • Optimal visualization strategies for AR-guided pedicle screw trajectory remain an open research question.

Purpose of the Study:

  • To compare the effectiveness of different augmented reality (AR) visualizations for pedicle screw trajectory guidance.
  • To evaluate how visualization design impacts surgical accuracy, efficiency, and user experience in spinal fusion surgery.

Main Methods:

  • Five AR visualizations (varying abstraction, position, dimensionality) were tested using Microsoft HoloLens 2.
  • Surgeons (experts and novices) performed pedicle screw placement on lumbar spine models.
  • Evaluated metrics included trajectory deviations, dwell times, and user experience compared to standard navigation.

Main Results:

  • Two AR visualizations significantly reduced trajectory deviations compared to standard navigation.
  • Abstract, peripherally displayed, and 3D anatomical, offset visualizations yielded better ease of use and lower cognitive load.
  • Participant groups (experts vs. novices) showed no significant performance differences, suggesting AR's leveling effect.

Conclusions:

  • AR visualization design critically impacts surgical performance, visual attention, and user experience in pedicle screw placement.
  • Both abstract and anatomical AR visualizations are effective when not occluding the surgical site.
  • Peripheral anchoring of information enhances AR navigation benefits, potentially leveling performance between surgical experts and novices.