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Augmented reality to visualize nerve segmentation intraoperatively for endoscopic discectomy
Isabella E Decker1, Felix Toussaint1, Meriem Boukhiam1
1Department of Neurosurgery, Duke Health, Durham, North Carolina.
Neurosurgical Focus: Video
|July 30, 2026
Summary
Augmented reality (AR) guidance combined with preoperative nerve segmentation enhances endoscopic discectomy safety and feasibility. This approach allows for effective decompression without foraminoplasty, improving patient outcomes.
Area of Science:
- Neurosurgery
- Medical Imaging
- Surgical Technology
Background:
- Intraoperative visualization is a significant challenge during endoscopic discectomy.
- Limited visualization can complicate nerve decompression and increase the risk of complications.
Purpose of the Study:
- To evaluate the safety and feasibility of using augmented reality (AR) guidance with preoperative nerve segmentation for endoscopic discectomy.
- To demonstrate a technique for nerve decompression without the need for foraminoplasty.
Main Methods:
- Preoperative MRI-based nerve segmentation was integrated with intraoperative CT imaging.
- Augmented reality (AR) visualization projected segmented spinal anatomy onto the patient in real time.
- A partial discectomy was performed to decompress the L2-3 nerve root.
Main Results:
- The procedure was successfully performed using AR guidance.
- The patient underwent nerve decompression without requiring a foraminoplasty.
- The patient tolerated the procedure well and experienced significant pain relief.
Conclusions:
- Augmented reality (AR) guidance, coupled with preoperative nerve segmentation, is a safe and feasible approach for endoscopic discectomy.
- This technique enables effective nerve decompression without foraminoplasty, offering a potential advancement in minimally invasive spine surgery.
