Application of a new wearable augmented reality video see-through display to aid percutaneous procedures in spine surgery

In mini-invasive surgery, the surgeon operates without a direct visualization of the patient’s anatomy. In image-guided surgery, solutions based on augmented reality (AR) represent the most promising ones. The aim of this study was to evaluate the efficacy of a new wearable AR system as aid in the performance of percutaneous procedures in spine surgery. Our solution is based on a video see-through head mounted display (HMD) and it allows the augmentation of video frames acquired by two external cameras with the rendering of patient-specific 3D models obtained elaborating radiological images. We tested the system on an in vitro setup intended to simulate the reaching of a lumbar pedicle. An experienced surgeon performed the percutaneous task wearing the HMD. System accuracy was evaluated through post-operative CT scan, measuring the maximum distance between the planned and obtained trajectories inside the pedicle canal. The mean insertion error was of 1.18 ±0.16 mm.