Augmented reality-guided pedicle screw fixation: an experimental study
- Author:
Sang-Min PARK
1
;
Dongjoon KIM
;
Jiwon PARK
;
Ho-Joong KIM
;
Jin S. YEOM
Author Information
- Publication Type:Basic Study
- From:Asian Spine Journal 2025;19(6):896-903
- CountryRepublic of Korea
- Language:English
-
Abstract:
Methods:Five porcine cadaveric lumbar spines were used in this study. A custom-developed head-mounted display system with optical tracking projected three-dimensional reconstructed spine models and planned screw trajectories into the surgeon’s field of view. A single experienced spine surgeon placed 50 pedicle screws (4.5 mm diameter). Registration was performed using a point-pair matching technique with fifteen anatomical landmarks. Accuracy was assessed via postoperative computed tomography scan, measuring entry point deviation, trajectory deviation, and angular difference, and evaluated using the Gertzbein-Robbins classification.
Results:Of the 50 pedicle screws placed, 47 (94%) achieved grade A accuracy with complete containment within the pedicle. The remaining three screws (6%) were classified as grade B, with minor breaches less than 2 mm. No unsafe placements (grades C–E) occurred. The mean entry point deviation was 0.55 mm (standard deviation [SD]=0.33 mm), and the mean deviation at the screw tip was 0.71 mm (SD=0.32 mm). The mean axial angular deviation was 2.04° (SD=0.58°). The average placement time was 2.2 minutes per screw.
Conclusions:The custom-developed ARPSF system demonstrated high accuracy for pedicle screw placement in a porcine model, achieving submillimeter precision and minimal angular deviation. This experimental study shows the potential of augmented reality technology to enhance spine instrumentation precision.
