Low-Cost Augmented Reality System in Endoscopic Spine Surgery: Analysis of Surgeon Ergonomics, Perceived Workload and...

Area of Science:

• Neurosurgery and Orthopedic Surgery
• Surgical Technology and Innovation
• Human Factors and Ergonomics

Background:

• Endoscopic spine surgery demands high cognitive and physical effort from surgeons.
• Traditional display monitors may contribute to surgeon fatigue and ergonomic strain.
• Novel visualization systems are needed to optimize surgical performance and well-being.

Purpose of the Study:

• To compare the impact of an augmented reality (AR) visualization system versus conventional displays on surgeon workload and ergonomics.
• To quantify changes in perceived workload using the NASA Task Load Index (NASA-TLX).
• To assess improvements in surgeon posture using the Rapid Upper Limb Assessment (RULA) score.

Main Methods:

• Prospective controlled study involving 10 experienced endoscopic spine surgeons.
• Surgeons performed 20 surgeries each, alternating between traditional displays and a novel AR system.
• Workload (NASA-TLX) and ergonomics (RULA) were assessed post-procedure for each system.

Main Results:

• The AR system led to significantly lower NASA-TLX scores, especially in physical demand, effort, and performance (P < 0.001).
• RULA scores improved significantly, decreasing from 6.0 with traditional displays to 3.0 with AR (P < 0.001).
• All surgeons reported reduced workload and ergonomic risk with the AR system.

Conclusions:

• Augmented reality visualization systems substantially decrease cognitive workload and enhance ergonomic posture in endoscopic spine surgery.
• AR technology offers potential benefits for surgical efficiency and surgeon well-being.
• AR integration may support the long-term sustainability of minimally invasive spinal procedures.