Spine surgeons at UC San Diego Health (San Diego, USA) have begun using augmented reality (AR) headsets that give them ‘X-ray vision’ during procedures for accurate and personalised implant placement, while allowing them to keep their eyes on their patients. It is believed that UC San Diego Health spine surgeons are the first on the US west coast to utilise AR in their practice.
The three-dimensional navigation system and headset allow surgeons to ‘see’ inside the body, helping them quickly and accurately place implants in each patient’s unique anatomy. This system, first used by the health system on April 1, 2021, lets surgeons maintain their focus directly on the patient, rather than on a distant screen displaying the patient’s CT scans.
Richard (Todd) Allen, was the first orthopaedic surgeon to use the system at UC San Diego Health. For him, the technology is like an advanced car navigation system except, instead of looking back and forth between the car’s screen and the road, the directions are superimposed on to the road ahead. Without the augmented reality headset, surgeons rely on feel, X-ray and CT images taken throughout the procedure.
The first time Allen used augmented reality was during a complicated spinal fusion procedure in which multiple vertebrae were brought together and stabilised with two rods and several screws. Allen said he and the operating team, which included Spine Fellow Paul Bagi, were able to accurately place the screws in approximately half the time it would normally require.
Allen commented: “Less time in the operating room typically means less blood loss, lower risks of related complications, and the potential for a more rapid recovery. Of course, saving time should never be at the expense of safety. But with this technology, we can decrease operative time while actually improving safety.
“My focus is to align the goals of spine surgery with those of each patient, so they receive personalised care. I strive to treat each patient as an individual, and understand what they want to get out of their surgery.”
Manufactured by Augmedics, the xvision Spine System headset is currently approved for use in open and minimally invasive spine implant procedures. These types of procedures are intended to treat a variety of conditions, including herniated discs, scoliosis, spinal fractures and spinal tumours.
The system consists of a headset with a transparent near-eye-display and navigation technology to determine the position of surgical tools in real-time and superimposes them on the patient’s CT scan image. The information is projected onto the surgeon’s retina using the headset, allowing the surgeon to simultaneously see the patients’ unique spinal anatomy from the side, the top and in three dimensions, with software allowing them to recreate the same trajectory for each tool used and during screw placement.