Medical Student Washington University School of Medicine Corpus Christi, Texas, United States
Introduction: Technological advancements in trauma medicine can improve the speed and accuracy of a physician’s care response with a major impact on downstream operative outcomes. Augmented reality head-mounted-display (AR-HMD) is a novel technology that provides surgeons with a real-time CT-guided 3-dimensional recapitulation of a patient’s spinal anatomy. In this case series, we explore the use of AR-HMD in spine trauma cases to determine its effect on perioperative outcomes such as surgery time, blood loss, length of hospital stay (LOS), and patient-reported outcomes measured through the Oswestry Disability Index (ODI).
Methods: We recruited a retrospective cohort of patients who underwent navigated pedicle screw placement guided by AR-HMD at the Barnes Jewish Hospital from January 1, 2021, to January 30, 2022. From this, a cohort of 7 traumatic cases were found where AR-HMD was utilized during surgery. Patient outcomes were collected and analyzed using SPSS.
Results: The cohort consisted of 4 males and 3 females with an average age of 65.57 years, BMI of 28.44, and Charlson Comorbidity Index of 3.86. Injury was assorted into one-level fracture (4), two-level fracture (2), and three-level fracture (1). The average surgical invasiveness index (SII) was 8.14. Intra-operatively, there was an average of 461.43ml blood lost, 1.14 transfusion units used, 460.43 minutes spent in the operating room, and LOS of 23.71 days. The average 3-month, 6-month, and 12-month ODI scores were 17.17 (N=6), 17.75 (N=5), and 12.67 (N=3), respectively.
Conclusion : The urgency to treat a spinal pathology constitutes a major hurdle for the adoption of novel technologies in spine surgery. The case series demonstrates the utility of AR-HMD in spinal surgery trauma cases with perioperative outcomes were comparable to those observed in robotic-assisted surgery. This is an early attempt to demonstrate that AR-HMD can provide equitable outcomes to traditional surgical practices.
