Related Experiment Video
Updated: Jul 10, 2026
06:18
Pedicle Screw Placement Using an Augmented Reality Head-Mounted Display in a Porcine Model
Published on: May 24, 2024
Mixed-reality, heads-up navigation for percutaneous pedicle screw placement: a prospective accuracy and workflow
Ruili Zhuo1, Hongrui Liu2, Wei Liang2
1Department of Spine Surgery, Puyang Oilfield General Hospital, No. 124 Daqing Road, Puyang, Henan Province, 457000, China. 13653930023@126.com.
3D Printing in Medicine
|July 8, 2026
Summary
Mixed-reality (MR) navigation improves spine surgery accuracy and speed compared to fluoroscopy. This technology offers enhanced precision, reduced operative time, and fewer complications for minimally invasive procedures.
Area of Science:
- Neurosurgery
- Medical Technology
- Surgical Navigation
Background:
- Mixed-reality (MR) head-mounted navigation offers potential for enhanced precision and speed in percutaneous pedicle screw fixation by projecting 3D spinal holograms.
- High-quality prospective data comparing MR navigation to conventional fluoroscopy is limited.
Purpose of the Study:
- To compare the precision and efficiency of MR head-mounted navigation with conventional fluoroscopy for percutaneous pedicle screw fixation.
Main Methods:
- A randomized study allocated 61 adult patients to either MR navigation (30 patients, 136 screws) or fluoroscopy (31 patients, 138 screws).
- Key outcomes included screw accuracy, operative time, deviation measurements, intra-operative fluoroscopic images, and complication rates.
Main Results:
- MR navigation resulted in a higher proportion of accurately placed screws (96.3% vs. 89.9%, p=0.04) and significantly reduced mean operative time by 28 minutes (p<0.001).
- MR navigation demonstrated smaller entry-point, angular, and depth deviations, with a 42% reduction in intra-operative fluoroscopic images.
- Early complications were lower in the MR group (3.3% vs. 16.1%), and holographic pre-operative counseling improved patient understanding and satisfaction (p<0.001).
Conclusions:
- MR head-mounted navigation is a feasible, safe, and more precise guidance method than fluoroscopy for minimally invasive spine surgery.
- The technology delivers faster procedures, reduces fluoroscopic exposure, and has a short learning curve, supporting its role as a cost-effective next-generation modality.
