{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:09:52Z","timestamp":1777950592473,"version":"3.51.4"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This article and accompanying video provide a comprehensive workflow for incorporating headset-mounted augmented reality (AR) navigation for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients undergoing a single level MIS-TLIF with AR navigation for degenerative spondylolisthesis were analyzed between January 2023\u20132025. Demographic, intraoperative, and postoperative outcomes were collected. The AR workflow features a wireless headset with projection of intraoperative navigation in the surgical field. MIS pedicle screw placement, facetectomy, disc preparation, and contralateral arthrodesis are carried out percutaneously though single line of sight using navigated instruments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      A total of 138 consecutive patients underwent AR-assisted spinal fusion at our institution and 22 cases of single-level MIS TLIF met inclusion criteria. Mean age was 62.3\u2009\u00b1\u200915 years, 59% were females, mean BMI was 29.4\u00b15.7\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and mean CCI score was 2.1\u00b11.5. The mean operative time from incision to closure for the entire cohort was 129\u00b128\u00a0min, mean fluoroscopy time was 41\u00b112\u00a0s, EBL was 51\u00b133\u00a0ml, and the mean length of stay was 1.9\u00b11.8 days. Two (9%) patients required reoperation at a mean 5 weeks. The AR protocol was safely implemented in all cases with improvement in back and leg pain and no persistent neurologic deficits at mean 163\u00a0day follow up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Headset-mounted AR navigation is a feasible and reproducible tool to provide visualization for MIS TLIF that can be successfully integrated into surgical workflow. In this initial case series, its use was associated with an acceptable early safety profile and consistent perioperative outcomes. However, given the limitations of this study, including its retrospective design and lack of a comparator cohort, further prospective and comparative studies are necessary to evaluate its impact on surgical efficiency, accuracy, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-026-09972-4","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:47:53Z","timestamp":1777880873000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Augmented reality assisted minimally invasive transforaminal lumbar interbody fusion: feasible and effective workflow with intraoperative video"],"prefix":"10.1007","author":[{"given":"Iyan","family":"Younus","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Garcia de Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Lipson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiyush","family":"Bansal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Louie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"9972_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.spinee.2023.08.015","volume":"24","author":"TD Azad","year":"2024","unstructured":"Azad TD, Warman A, Tracz JA, Hughes LP, Judy BF, Witham TF (2024) Augmented reality in spine surgery - past, present, and future. Spine J 24:1\u201313. https:\/\/doi.org\/10.1016\/j.spinee.2023.08.015","journal-title":"Spine J"},{"key":"9972_CR2","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1097\/BSD.0000000000001211","volume":"34","author":"Y Katsuura","year":"2021","unstructured":"Katsuura Y, Colon LF, Perez AA, Albert TJ, Qureshi SA (2021) A Primer on the Use of Artificial Intelligence in Spine Surgery. Clin Spine Surg 34:316\u2013321. https:\/\/doi.org\/10.1097\/BSD.0000000000001211","journal-title":"Clin Spine Surg"},{"key":"9972_CR3","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1093\/ons\/opaa398","volume":"20","author":"CA Molina","year":"2021","unstructured":"Molina CA, Sciubba DM, Greenberg JK, Khan M, Witham T (2021) Clinical Accuracy, Technical Precision, and Workflow of the First in Human Use of an Augmented-Reality Head-Mounted Display Stereotactic Navigation System for Spine Surgery. Oper Neurosurg (Hagerstown) 20:300\u2013309. https:\/\/doi.org\/10.1093\/ons\/opaa398","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"9972_CR4","doi-asserted-by":"publisher","first-page":"2047","DOI":"10.1177\/21925682211069321","volume":"13","author":"FR Bhatt","year":"2023","unstructured":"Bhatt FR, Orosz LD, Tewari A, Boyd D, Roy R, Good CR, Schuler TC, Haines CM, Jazini E (2023) Augmented Reality-Assisted Spine Surgery: An Early Experience Demonstrating Safety and Accuracy with 218 Screws. Global Spine J 13:2047\u20132052. https:\/\/doi.org\/10.1177\/21925682211069321","journal-title":"Global Spine J"},{"key":"9972_CR5","doi-asserted-by":"publisher","unstructured":"Pahwa B, Azad TD, Liu J, Ran K, Liu CJ, Tracz J, Sattari SA, Khalifeh JM, Judy BF, Bydon A, Witham TF (2023) Assessing the Accuracy of Spinal Instrumentation Using Augmented Reality (AR): A Systematic Review of the Literature and Meta-Analysis. J Clin Med 12. https:\/\/doi.org\/10.3390\/jcm12216741","DOI":"10.3390\/jcm12216741"},{"key":"9972_CR6","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.wneu.2023.02.068","volume":"173","author":"K McCloskey","year":"2023","unstructured":"McCloskey K, Turlip R, Ahmad HS, Ghenbot YG, Chauhan D, Yoon JW (2023) Virtual and Augmented Reality in Spine Surgery: A Systematic Review. World Neurosurg 173:96\u2013107. https:\/\/doi.org\/10.1016\/j.wneu.2023.02.068","journal-title":"World Neurosurg"},{"key":"9972_CR7","doi-asserted-by":"publisher","unstructured":"Moga K, Holgyesi A, Zrubka Z, Pentek M, Haidegger T (2023) Augmented or Mixed Reality Enhanced Head-Mounted Display Navigation for In Vivo Spine Surgery: A Systematic Review of Clinical Outcomes. J Clin Med 12. https:\/\/doi.org\/10.3390\/jcm12113788","DOI":"10.3390\/jcm12113788"},{"key":"9972_CR8","doi-asserted-by":"publisher","first-page":"e8","DOI":"10.1016\/j.wneu.2021.08.002","volume":"161","author":"H Sumdani","year":"2022","unstructured":"Sumdani H, Aguilar-Salinas P, Avila MJ, Barber SR, Dumont T (2022) Utility of Augmented Reality and Virtual Reality in Spine Surgery: A Systematic Review of the Literature. World Neurosurg 161:e8\u2013e17. https:\/\/doi.org\/10.1016\/j.wneu.2021.08.002","journal-title":"World Neurosurg"},{"key":"9972_CR9","doi-asserted-by":"publisher","unstructured":"Xiao SX, Wu WT, Yu TC, Chen IH, Yeh KT (2024) Augmenting Reality in Spinal Surgery: A Narrative Review of Augmented Reality Applications in Pedicle Screw Instrumentation. Med (Kaunas) 60. https:\/\/doi.org\/10.3390\/medicina60091485","DOI":"10.3390\/medicina60091485"},{"key":"9972_CR10","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1007\/s00586-023-08094-5","volume":"33","author":"S Youssef","year":"2024","unstructured":"Youssef S, McDonnell JM, Wilson KV, Turley L, Cunniffe G, Morris S, Darwish S, Butler JS (2024) Accuracy of augmented reality-assisted pedicle screw placement: a systematic review. Eur Spine J 33:974\u2013984. https:\/\/doi.org\/10.1007\/s00586-023-08094-5","journal-title":"Eur Spine J"},{"key":"9972_CR11","doi-asserted-by":"publisher","first-page":"S85","DOI":"10.1093\/ons\/opab114","volume":"21","author":"J Godzik","year":"2021","unstructured":"Godzik J, Farber SH, Urakov T, Steinberger J, Knipscher LJ, Ehredt RB, Tumialan LM, Uribe JS (2021) Disruptive Technology in Spine Surgery and Education: Virtual and Augmented Reality. Oper Neurosurg (Hagerstown) 21:S85\u2013S93. https:\/\/doi.org\/10.1093\/ons\/opab114","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"9972_CR12","doi-asserted-by":"publisher","first-page":"S22","DOI":"10.14444\/8273","volume":"16","author":"AJ Rush 3rd","year":"2022","unstructured":"Rush AJ 3rd, Shepard N, Nolte M, Siemionow K, Phillips F (2022) Augmented Reality in Spine Surgery: Current State of the Art. Int J Spine Surg 16:S22\u2013S27. https:\/\/doi.org\/10.14444\/8273","journal-title":"Int J Spine Surg"},{"key":"9972_CR13","doi-asserted-by":"publisher","first-page":"574","DOI":"10.14245\/ns.2244134.067","volume":"19","author":"F Sommer","year":"2022","unstructured":"Sommer F, Hussain I, Kirnaz S, Goldberg JL, Navarro-Ramirez R, McGrath LB Jr., Schmidt FA, Medary B, Gadjradj PS, Hartl R (2022) Augmented Reality to Improve Surgical Workflow in Minimally Invasive Transforaminal Lumbar Interbody Fusion - A Feasibility Study With Case Series. Neurospine 19:574\u2013585. https:\/\/doi.org\/10.14245\/ns.2244134.067","journal-title":"Neurospine"},{"key":"9972_CR14","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1227\/ons.0000000000001027","volume":"26","author":"HA Leroy","year":"2024","unstructured":"Leroy HA, Vaziri S, Assaker R, Wang MY (2024) Digital Tubular-Based Camera-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 26:481\u2013482. https:\/\/doi.org\/10.1227\/ons.0000000000001027","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"9972_CR15","doi-asserted-by":"publisher","first-page":"S64","DOI":"10.14444\/8643","volume":"18","author":"A Sarikonda","year":"2024","unstructured":"Sarikonda A, Sivaganesan A, Qureshi S (2024) Advanced Visualization in Minimally Invasive Spine Surgery: The Ergonomics, Economics, and Evolution of Camera-Based Tubes and Retractors. Int J Spine Surg 18:S64\u2013S70. https:\/\/doi.org\/10.14444\/8643","journal-title":"Int J Spine Surg"},{"key":"9972_CR16","doi-asserted-by":"publisher","unstructured":"Bui T, Ruiz-Cardozo MA, Dave HS, Barot K, Kann MR, Joseph K, Lopez-Alviar S, Trevino G, Brehm S, Yahanda AT, Molina CA (2024) Virtual, Augmented, and Mixed Reality Applications for Surgical Rehearsal, Operative Execution, and Patient Education in Spine Surgery: A Scoping Review. Med (Kaunas) 60. https:\/\/doi.org\/10.3390\/medicina60020332","DOI":"10.3390\/medicina60020332"},{"key":"9972_CR17","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.wneu.2022.10.002","volume":"168","author":"S Durrani","year":"2022","unstructured":"Durrani S, Onyedimma C, Jarrah R, Bhatti A, Nathani KR, Bhandarkar AR, Mualem W, Ghaith AK, Zamanian C, Michalopoulos GD, Alexander AY, Jean W, Bydon M (2022) The Virtual Vision of Neurosurgery: How Augmented Reality and Virtual Reality are Transforming the Neurosurgical Operating Room. World Neurosurg 168:190\u2013201. https:\/\/doi.org\/10.1016\/j.wneu.2022.10.002","journal-title":"World Neurosurg"},{"key":"9972_CR18","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1227\/ons.0000000000001317","volume":"28","author":"FA Schmidt","year":"2025","unstructured":"Schmidt FA, Hussain I, Boadi B, Sommer FJ, Thome C, Hartl R (2025) The Use of Augmented Reality as an Educational Tool in Minimally Invasive Transforaminal Lumbar Interbody Fusion. Oper Neurosurg (Hagerstown) 28:183\u2013192. https:\/\/doi.org\/10.1227\/ons.0000000000001317","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"9972_CR19","doi-asserted-by":"publisher","first-page":"3551","DOI":"10.1007\/s00586-022-07397-3","volume":"31","author":"Y Ahn","year":"2022","unstructured":"Ahn Y, Lee S, Kim WK, Lee SG (2022) Learning curve for minimally invasive transforaminal lumbar interbody fusion: a systematic review. Eur Spine J 31:3551\u20133559. https:\/\/doi.org\/10.1007\/s00586-022-07397-3","journal-title":"Eur Spine J"},{"key":"9972_CR20","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2013.5.FOCUS13157","volume":"35","author":"PS Silva","year":"2013","unstructured":"Silva PS, Pereira P, Monteiro P, Silva PA, Vaz R (2013) Learning curve and complications of minimally invasive transforaminal lumbar interbody fusion. Neurosurg Focus 35:E7. https:\/\/doi.org\/10.3171\/2013.5.FOCUS13157","journal-title":"Neurosurg Focus"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-026-09972-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-026-09972-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-026-09972-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:47:54Z","timestamp":1777880874000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-026-09972-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":20,"alternative-id":["9972"],"URL":"https:\/\/doi.org\/10.1007\/s00586-026-09972-4","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"23 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 April 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 April 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}