Alexander Satin, a spine surgeon at the Texas Back Institute (Frisco, USA), speaks to Spinal News International about the reasons why he uses augmented reality (AR) in his practice. He outlines some of the key benefits as well as downsides of the technology and considers what the future of spine surgery might look with a greater adoption of AR.
Do you currently use AR in your practice?
I do not currently utilise AR in the operating room (OR). However, I have recently starting using AR in my office for patient education prior to surgery. Through the AR headset, I am able to provide a comprehensive visual representation of the patient’s pathology and show them a step-by-step example of their surgery. I think this far exceeds what we can show patients with magnetic resonance imaging (MRI) review and surgical models. Research is needed to show how this impacts patient satisfaction and understanding compared to traditional preoperative education techniques.
Why did you choose to incorporate AR technology?
I chose to utilise AR technology for a number of reasons. First and foremost, for my patients—I think it enhances their understanding of spinal pathology and the planned surgical treatment. Second, I believe that it will eventually become ubiquitous within spine surgery.
What are the main benefits of AR and how can it help improve outcomes?
AR platforms reduce OR clutter and line-of-sight issues compared to navigation and robotics systems. The surgeon can rely on their headset as opposed to a screen, which allows for direct visualisation and more ergonomic position. Eventually the incorporation of MRI images will dramatically enhance our ability to appreciate soft tissue structures and hopefully reduce surgical morbidity.
Spinal News International recently ran a poll asking physicians whether or not they currently use or would be open to using AR in their practice. The results were as follows:
What are the main barriers to adoption of this technology?
While current AR platforms are less expensive than other robotics and navigation systems, the initial capital costs are still high. Disposable costs for each case make it less appealing to the ambulatory surgery centre and/or surgeon owned facility. Currently available platforms also require an intraoperative computerised tomography (CT) scan (as opposed to a preoperative CT scan). This dramatically increases initial capital costs if you don’t already have access to intraoperative CT scan technology. Eye fatigue and neck pain are concerns that should be addressed with future iterations of the technology.
What does the future of spine surgery look like to you?
The future is bright for AR technology. I believe we will eventually see the amalgamation of AR, robotics, navigation, and endoscopy. These combined platforms will provide surgeons with unparalleled visualisation while increasing safety and reducing surgical morbidity.
Alexander Satin is a spine surgeon at the Texas Back Institute (Frisco, USA). He graduated with honours from Johns Hopkins University after earning a degree in Biophysics. He received his medical degree from the Albert Einstein College of Medicine. He completed his orthopaedic surgery residency at the Hofstra University-Northwell Health system in New York. Following his residency, Satin completed a spine surgery fellowship at the Texas Back Institute.
Relevant disclosures: DeGen Medical (royalties and consulting)