• Augmented Reality Versus Freeh...

*Result*: Augmented Reality Versus Freehand Spinopelvic Fixation in Spinal Deformity: A Case-Control Study.

Title:
Augmented Reality Versus Freehand Spinopelvic Fixation in Spinal Deformity: A Case-Control Study.
Authors:
Azad TD; Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA., Alfonzo Horowitz M; Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA., Tracz JA; Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA., Khalifeh JM; Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA., Liu CJ; Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA., Hughes LP; Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA., Judy BF; Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA., Khan M; Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, USA., Bydon A; Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA., Witham TF; Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Source:
Surgical innovation [Surg Innov] 2025 Feb; Vol. 32 (1), pp. 36-45. Date of Electronic Publication: 2024 Nov 08.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Sage Publications Country of Publication: United States NLM ID: 101233809 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1553-3514 (Electronic) Linking ISSN: 15533506 NLM ISO Abbreviation: Surg Innov Subsets: MEDLINE
Imprint Name(s):
Original Publication: Thousand Oaks, CA : Sage Publications
MeSH Terms:
Augmented Reality* , Spinal Curvatures*/surgery , Surgery, Computer-Assisted*/methods, Humans ; Female ; Case-Control Studies ; Male ; Aged ; Bone Screws ; Middle Aged ; Pelvis/surgery ; Adult
Contributed Indexing:
Keywords: augmented reality; lumbo-pelvic fixation; navigation; sacral-alar-iliac; spinopelvic fixation
Entry Date(s):
Date Created: 20241108 Date Completed: 20250115 Latest Revision: 20250516
Update Code:
20260130
DOI:
10.1177/15533506241299887
PMID:
39516001
Database:
MEDLINE

*Further Information*

*Purpose: This study sought to compare screw placement accuracy and outcomes between freehand (FH) and AR-guided pelvic fixation. While pelvic fixation is a critical technique in spinal deformity surgery, S2-alar iliac (S2AI) screw placement poses challenges.
Methods: We conducted a case-control study of 50 consecutive patients who underwent spinopelvic fixation at a single institution. AR guidance was performed using a head-mounted display (Xvision, Augmedics). Patient demographics, surgical characteristics, spinopelvic parameters, and screw breach grade were compared using univariate and multivariate statistics.
Results: Pelvic fixation was performed FH in 21 patients (median age, 64; female, 38.1%; median BMI 32.3 kg/m <sup>2</sup> ) and AR-guided in 29 patients (median age, 66; female, 51.7%; median BMI 28.4 kg/m <sup>2</sup> ). Mean follow-up was longer in the FH group (28 mos vs 11 mos, P < 0.001). Pelvic fixation in the FH group was performed using either S2AI (90.5%) or dual S2AI (9.5%) screws. There were no significant differences in length of surgery (FH, 439 minutes; AR, 490 minutes; P = 0.1) or estimated blood loss (FH, 2.1L; AR, 1.9L; P = 0.7). Accuracy of FH pelvic fixation was 95.6% (43/45 screws) and accuracy of AR pelvic fixation was 96.5% (55/57 screws). Multivariable logistic regression for screw breach revealed no significant association with AR guidance when controlling for age, BMI, osteoporosis, and smoking.
Conclusions: We present the first case-control study of AR-guided spinopelvic fixation, with findings suggesting parity between FH and AR-guidance, serving as foundation for prospective controlled studies with longitudinal follow-up to interrogate the benefits of AR-guidance in spinal deformity surgery.*

*Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.*