Augmented reality to visualize nerve segmentation intraoperatively for endoscopic discectomy

Intraoperative visualization throughout endoscopic discectomy remains limited. A 70-year-old female presented with a left-sided L2-3 disc herniation. Preoperative MRI-based nerve segmentation was integrated with intraoperative CT imaging to generate a virtual operative field. Augmented reality (AR) visualization was used to project the segmented spinal anatomy onto the patient in real time. A partial discectomy was performed to decompress the affected nerves without the need for a foraminoplasty. The patient tolerated the procedure well with significant pain relief. This case study demonstrates the safety and feasibility of endoscopic discectomy without foraminoplasty with the aid of AR guidance with preoperative nerve segmentation. The video can be found here: https://stream.cadmore.media/r10.3171/2026.4.FOCVID2650.