College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Eastern Virginia Medical School, Norfolk, VA 23507, USA.
Medicina (Kaunas). 2023 Sep 26;59(10):1721. doi: 10.3390/medicina59101721.
Augmented reality (AR) involves the overlay of computer-generated images onto the user's real-world visual field to modify or enhance the user's visual experience. With respect to neurosurgery, AR integrates preoperative and intraoperative imaging data to create an enriched surgical experience that has been shown to improve surgical planning, refine neuronavigation, and reduce operation time. In addition, AR has the potential to serve as a valuable training tool for neurosurgeons in a way that minimizes patient risk while facilitating comprehensive training opportunities. The increased use of AR in neurosurgery over the past decade has led to innovative research endeavors aiming to develop novel, more efficient AR systems while also improving and refining present ones. In this review, we provide a concise overview of AR, detail current and emerging uses of AR in neurosurgery and neurosurgical training, discuss the limitations of AR, and provide future research directions. Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 386 articles were initially identified. Two independent reviewers (GH and AC) assessed article eligibility for inclusion, and 31 articles are included in this review. The literature search included original (retrospective and prospective) articles and case reports published in English between 2013 and 2023. AR assistance has shown promise within neuro-oncology, spinal neurosurgery, neurovascular surgery, skull-base surgery, and pediatric neurosurgery. Intraoperative use of AR was found to primarily assist with surgical planning and neuronavigation. Similarly, AR assistance for neurosurgical training focused primarily on surgical planning and neuronavigation. However, studies included in this review utilize small sample sizes and remain largely in the preliminary phase. Thus, future research must be conducted to further refine AR systems before widespread intraoperative and educational use.
增强现实（AR）涉及将计算机生成的图像叠加到用户的真实视觉场中，以修改或增强用户的视觉体验。在神经外科领域，AR 将术前和术中的成像数据集成在一起，创建了一种丰富的手术体验，已被证明可以改善手术规划、完善神经导航并缩短手术时间。此外，AR 有可能成为神经外科医生的宝贵培训工具，可以在最大限度降低患者风险的同时，提供全面的培训机会。在过去十年中，神经外科中 AR 的使用越来越多，这导致了旨在开发新型、更高效 AR 系统的创新研究努力，同时也改进和完善了现有的系统。在这篇综述中，我们提供了一个关于 AR 的简要概述，详细介绍了 AR 在神经外科和神经外科培训中的当前和新兴用途，讨论了 AR 的局限性，并提供了未来的研究方向。根据系统评价和荟萃分析的首选报告项目（PRISMA）的指南，最初确定了 386 篇文章。两名独立的审稿人（GH 和 AC）评估了纳入文章的资格，共有 31 篇文章被纳入本综述。文献检索包括 2013 年至 2023 年期间以英文发表的原始（回顾性和前瞻性）文章和病例报告。AR 辅助在神经肿瘤学、脊柱神经外科、神经血管外科、颅底外科和小儿神经外科中显示出了一定的应用前景。术中使用 AR 主要用于辅助手术规划和神经导航。同样，AR 辅助神经外科培训主要侧重于手术规划和神经导航。然而，本综述中纳入的研究使用的样本量较小，且仍处于初步阶段。因此，必须进行未来的研究来进一步改进 AR 系统，然后才能广泛应用于术中及教育领域。
