Four spine surgeons discuss innovations in augmented reality and the developments they are most excited about in the field.
Frank Phillips, MD. Rush University Medical Center (Chicago): I am particularly excited by the use of AR in spine surgery. Recently the FDA has approved a unique system that comprises a headset with integrated tracking cameras and direct retinal near-eye display that provides for virtual 3D visualization of the spinal anatomy as well as standard 2D CT navigation images. At Rush we performed the cadaveric testing of this system that resulted in FDA approval, and I was highly impressed with the advantages this system provides.
Christopher Good, MD. Virginia Spine Institute (Reston): I foresee the modern OR using AR not only to enhance navigation and instrumentation, but to also provide surgeons endoscopic or magnified views of the patient's anatomy, and to superimpose clinical and radiographic data all on a simple to use heads-up display. I see this as a huge breakthrough with the potential to streamline and partner several technologies in the OR. We have already seen this technology incorporated into many areas outside of medicine. I believe there will be a strong patient interest and demand for AR as we continue to push to make our surgeries safer and less invasive.
Raymond Hah, MD. Keck School of Medicine of USC (Los Angeles): I am very excited to see the way that robotics will be applied beyond the limited scope of assisting planned pedicle screw placement, including potential motion restriction for "no-fly zones," automation of surgical decompression, and use of artificial intelligence and machine learning for anatomy recognition and guidance of surgical execution. An interesting overlap will be as AR becomes available in a commercially applicable fashion and the ways that this may assist surgeons intraoperatively. This could also prove to be an extremely valuable tool for presurgical planning as well as patient education.
Brian Gantwerker, MD. Craniospinal Center of Los Angeles: The next big innovation will be the development of a spinal robot that actually helps us do the surgery part of the operation. While the placement of pedicle screws with robots is making surgery safer, it is not the game- changer we are waiting for. When we can marry intraoperative visualization with augmented reality and a robot, then you're talking revolution.