Augmented Reality-Supported Rod Bending in Multilevel Spinal Fusion Using the ADVISE Software

Area of Science:

• Spine surgery
• Medical device technology
• Augmented reality applications

Background:

• Hardware failure, including screw loosening or pullout, is a common cause of poor outcomes and revision surgery in spinal fusion, affecting up to 25% of cases.
• Even minor screw-rod misalignments during spinal fusion surgery can lead to significant mechanical stress and subsequent hardware failure.

Purpose of the Study:

• To develop and evaluate a novel augmented reality-assisted software for creating patient-specific rod templates in spinal fusion.
• To address the critical surgical step of rod fixation and mitigate hardware failure due to misalignment.

Main Methods:

• The software utilizes a tablet-based augmented reality system integrated with a specific pedicle screw system featuring detachable guides.
• The system employs a tablet camera and a light detection and ranging scanner to identify screw heads and determine their spatial positions.
• Image data is processed to calculate an ideally fitting rod template tailored to the individual patient's anatomy.

Main Results:

• A 1:1 scale, custom rod template is displayed on the tablet screen for intraoperative use.
• Surgeons use the template to cut and bend the pedicle screw system's rods, creating a custom-fit rod.
• The custom-bent rod is designed for tension-free insertion into the screw heads.

Conclusions:

• The augmented reality software provides surgeons with patient-specific, real-time intraoperative data.
• This enables more precise rod bending compared to traditional freehand techniques.
• The technology aims to improve the accuracy of rod adaptation, potentially reducing hardware complications and enhancing surgical outcomes.