Why 6 spine surgeons are excited about augmented reality

Spinal Tech

Interest in augmented reality has spiked over the past decade, stemming from a desire to limit complications associated with instrumented spine surgery and improve procedural efficiency.

AR spine surgery surgery has made a lot of noise in the medtech industry since Augmedics launched its Xvision system in 2019, and many surgeons are excited about how the technology will integrate with other enabling technologies.

Six spine surgeons share their experiences with AR and predict how the technology will grow in the specialty:

Note: Responses were lightly edited for style and clarity.

Frank Phillips, MD. Midwest Orthopaedics at Rush (Chicago): I have used AR for the past two years, and it has been a breath of fresh air. This eliminates the cumbersome and time-consuming set up of robots at a fraction of the price. In addition, the use of AR in percutaneous spinal procedures provides surgeons with a 3D view of the spinal anatomy and allows visual and tactile feedback, which are sacrificed by current robots. I'm looking forward to seeing AR technologies combined with robotics to optimize outcomes.

Vik Mehta, MD. Hoag Hospital (Newport Beach, Calif.): I believe 2022 is the year AR comes into its own for spinal surgery. At Hoag, for example, my colleagues recently published a peer-reviewed study in Neurosurgical Focus, assessing the accuracy of screw placement using SpineAR, a navigation-guided spine surgery platform that incorporates real-time navigation images from intraoperative imaging with a 3D-reconstructed model in the surgeon's field of view. The results were excitingly positive, and I believe as more data comes in about the improved safety and efficacy, we will truly be at the dawn of the AR era in spine surgery.

Daniel Yanni, MD. Hoag Hospital (Newport Beach, Calif.): The emerging spine tech that's going to take off in the next five years is AR. While we are continuing to improve on biologics, hardware and robotics, nothing is as groundbreaking as the advancements being made in AR. This technology expands the amenities of a multimillion-dollar operating theater to a whole new reality, utilizing a portable headset that can be used anywhere, in any operating room. It is analogous to bringing the Iron Man helmet to your local surgeon.

AR technology allows surgeons to enhance what they see during a procedure with real-time 3D guidance and feedback based on a hologram-like reconstruction of the body. With access to multiple displays inside a single set of AR goggles, surgeons can customize their surgical suite. The AR overlays include a wide variety of information, from 3D reconstructions, source imaging (CT, MRI, angiography) and any other data source tailored to the surgeon's preference and comfort.

AR results in more efficient and less invasive surgeries, streamlined surgical planning, less exposure to X-ray radiation and optimal surgical precision. Surgeons at all levels can benefit from this technology. Even preliminary studies are showing significant improvement in trainee accuracy. 

Mohammed Faraz Khan, MD. New Jersey Brain & Spine (Oradell): I think AR will really take off. With Web 3.0 and the Metaverse buzz in full gear, I anticipate that spine techniques courses and meetings will likely shift toward a convenient format of AR where we will soon be attending the spine event in a virtual land just by putting on a VR headset in our living room.

John Burleson, MD. Hughston Clinic Orthopaedics (Nashville, Tenn.): I think AR really is the future of specialized orthopedic and spine surgery. Robotics might be the answer in the future as well, but over the next three years, the price point doesn't make sense for most surgery centers.

Alok Sharan, MD. NJ Spine and Wellness (East Brunswick, N.J.): I think the next big game-changer in spine surgery will be the common use of virtual surgery tools, such as AR glasses. These glasses, along with the technologies that will allow other surgeons to proctor a surgeon in another state or country, will help improve the quality and efficiency of surgeons. As there is a greater emphasis on quality and outcomes, surgeons will have to ensure that they are able to produce reproducible results. This will require virtual coaching by other surgeons who can help a surgeon attain higher quality and efficiency in the OR.

Currently, to learn a new technique, a surgeon has to travel to a weekend course. This becomes burdensome in terms of time off from your practice and personal obligations. With AR glasses, surgeons will be able to learn new techniques and also improve their current surgical techniques.

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