Nadeem-Tariq Ahmed, Kazemeini Sarah, Kaur Pratiksha, Dang Grace, Davis Trevor, Sraa Kiratpreet, Zitser Philip, Fang Christopher
Otolaryngology - Head and Neck Surgery, University of Nevada, Las Vegas (UNLV) School of Medicine, Las Vegas, USA.
Medical Education, University of Nevada, Las Vegas (UNLV) School of Medicine, Las Vegas, USA.
Cureus. 2025 Jun 26;17(6):e86803. doi: 10.7759/cureus.86803. eCollection 2025 Jun.
Augmented reality (AR) has emerged as a promising intraoperative navigation tool in spine surgery, particularly for pedicle screw placement, which demands high spatial precision and carries risks of neurovascular injury. AR platforms offer real-time overlays of patient anatomy, aiming to enhance accuracy, reduce radiation exposure, and streamline operative workflow. This narrative review synthesizes the early clinical experiences, efficacy data, and barriers to adoption for AR-assisted navigation in spine surgery. It also explores the role of AR in surgical training, workflow optimization, and future integration into routine practice. A comprehensive search of PubMed and ScienceDirect was conducted for English-language studies from January 2004 to May 2025. Inclusion criteria focused on peer-reviewed trials evaluating AR in spinal procedures, with outcomes including screw placement accuracy, radiation exposure, operative time, and user experience. Across multiple platforms, including Microsoft HoloLens and Augmedics xVision, AR-assisted navigation demonstrated pedicle screw placement accuracy rates ranging from 93% to 100%, often with reduced fluoroscopy time and improved surgeon ergonomics. Preliminary data suggest utility in complex deformity surgeries and surgical training. However, widespread adoption remains limited by cost, integration challenges, and a lack of large-scale, multicenter trials. AR represents a viable adjunct to current navigation technologies in spine surgery, showing early promise in enhancing precision and efficiency. Broader adoption will require improved validation, standardization of training protocols, and cost-effectiveness data.
增强现实（AR）已成为脊柱手术中一种很有前景的术中导航工具，尤其是在椎弓根螺钉置入方面，该操作需要高精度的空间定位，且存在神经血管损伤风险。AR平台可提供患者解剖结构的实时叠加影像，旨在提高准确性、减少辐射暴露并简化手术流程。这篇叙述性综述综合了脊柱手术中AR辅助导航的早期临床经验、疗效数据以及应用障碍。它还探讨了AR在手术培训、工作流程优化以及未来融入常规实践中的作用。对PubMed和ScienceDirect进行了全面检索，以查找2004年1月至2025年5月期间的英文研究。纳入标准侧重于评估脊柱手术中AR的同行评审试验，结果包括螺钉置入准确性、辐射暴露、手术时间和用户体验。在包括微软HoloLens和Augmedics xVision在内的多个平台上，AR辅助导航的椎弓根螺钉置入准确率在93%至100%之间，通常透视时间减少，外科医生的操作舒适度提高。初步数据表明其在复杂畸形手术和手术培训中具有应用价值。然而，由于成本、集成挑战以及缺乏大规模多中心试验，其广泛应用仍然有限。AR是脊柱手术中当前导航技术的一种可行辅助手段，在提高精度和效率方面显示出早期前景。更广泛的应用将需要改进验证、规范培训方案并提供成本效益数据。
