The clinical value and application of augmented reality navigation in brachial plexus schwannoma

This study aimed to introduce the application of magnetic resonance imaging (MRI)-derived augmented reality (AR) navigation in the surgical treatment of brachial plexus schwannomas and to evaluate and statistically analyze their clinical outcomes. Preoperative MRI data were converted into 3D reconstructions and AR holograms. Using mixed-reality glasses, surgeons employed these reconstructions for intraoperative tumor localization and surgical planning. Outcomes were assessed through structural visualization metrics (tumor, arteries, veins, and nerves) and clinical parameters (incision length, operative time, intraoperative blood loss, postoperative complications, satisfaction, and Quick-DASH scores). Twelve patients (mean age 44.75 ± 3.76 years) successfully underwent tumor resection. Compared to conventional MRI, AR demonstrated superior visualization of tumors (p < 0.0001), arteries (p = 0.0004), veins (p < 0.0001) and nerves (p < 0.0001). Although there was no significant change in incision length, intraoperative blood loss and Quick-DASH, AR navigation significantly reduced operative time (p = 0.04) and improved satisfaction score (p = 0.03). AR navigation enables intuitive surgical planning to circumvent critical neurovascular structures, thereby enhancing procedural safety for brachial plexus schwannoma resection, which makes it a promising adjunctive technique.