Augmented Reality Versus Freehand Spinopelvic Fixation in Spinal Deformity: A Case-Control Study

Area of Science:

• Spinal Surgery
• Orthopedic Technology
• Surgical Navigation

Background:

• Pelvic fixation is crucial in spinal deformity surgery.
• S2-alar iliac (S2AI) screw placement presents technical challenges.
• Freehand (FH) techniques require high precision.

Purpose of the Study:

• To compare screw placement accuracy and outcomes between freehand (FH) and augmented reality (AR)-guided pelvic fixation.
• To evaluate the feasibility and initial results of AR-guided spinopelvic fixation.

Main Methods:

• A case-control study involving 50 patients undergoing spinopelvic fixation.
• AR guidance utilized a head-mounted display (Xvision, Augmedics).
• Comparison of patient demographics, surgical characteristics, spinopelvic parameters, and screw breach using statistical analyses.

Main Results:

• No significant differences in surgery duration or estimated blood loss between FH and AR groups.
• Screw accuracy was high in both groups: 95.6% for FH and 96.5% for AR.
• Multivariable analysis showed no significant association between AR guidance and screw breach.

Conclusions:

• This is the first case-control study on AR-guided spinopelvic fixation.
• Findings suggest comparable accuracy and outcomes between FH and AR-guided techniques.
• Results provide a foundation for prospective studies investigating AR benefits in spinal deformity surgery.