{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T13:10:59Z","timestamp":1766754659688,"version":"3.41.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["11502146"],"award-info":[{"award-number":["11502146"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n               Background\u2003Augmented reality is a new technology that, when applied to spinal surgery, offers the potential for efficient, safe, and accurate placement of pedicle screws. This study investigated whether augmented reality combined with a guide board improved the safety and accuracy of pedicle screw placement compared to traditional freehand screw placement.<\/jats:p><jats:p>\n               Methods\u2003Four trainers were divided into augmented reality navigation and freehand groups. Each group consisted of a novice and an experienced spine surgeon. A total of 80 pedicle screws were implanted. First, the AR group reconstructed the three-dimensional (3D) model and planned the screw insertion route according to the computed tomography (CT) data of L2 lumbar vertebrae. Next, the Microsoft HoloLens 2 was used to identify the vertebral model, and the planned virtual path was superimposed on the real cone model. Then, the screw was placed according to the projected trajectory. Finally, Micron Tracker was used to measure the deviation of screws from the preoperatively planned trajectory, and pedicle screws were evaluated using the Gertzbein\u2013Robbins scale.<\/jats:p><jats:p>\n               Results\u2003In the augmented reality group, the linear deviation of the experienced doctors and novices was 1.59\u2009\u00b1\u20090.39 and 1.73\u2009\u00b1\u20090.52\u2009mm, respectively, and the deviation angle was 2.72\u2009\u00b1\u20090.61 and 2.87\u2009\u00b1\u20090.63\u2009degrees, respectively. In the freehand group, the linear deviation of the experienced doctors and novices was 2.88\u2009\u00b1\u20090.58 and 5.25\u2009\u00b1\u20090.62\u2009mm, respectively, and the deviation angle was 4.41\u2009\u00b1\u20091.18 and 7.15\u2009\u00b1\u20091.45\u2009degrees, respectively. The screw placement accuracy rate was 97.5% in the augmented reality navigation group and 77.5% in the freehand group.<\/jats:p><jats:p>\n               Conclusions\u2003Augmented reality navigation improves the accuracy and safety of pedicle screw implantation compared with the traditional freehand method and can assist inexperienced doctors in successfully completing the surgery.<\/jats:p>","DOI":"10.1055\/a-2200-3585","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T23:04:10Z","timestamp":1698447850000},"page":"383-389","source":"Crossref","is-referenced-by-count":4,"title":["A Novel Pedicle Screw Placement Surgery Based on Integration of Surgical Guides and Augmented Reality"],"prefix":"10.1055","volume":"86","author":[{"given":"Huiyang","family":"Kong","sequence":"additional","affiliation":[{"name":"School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuyi","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Can","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China"},{"name":"China International Neuroscience Institute (China-INI), Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhanglei","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiayu","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"issue":"17","key":"ref1","doi-asserted-by":"crossref","first-page":"E1085","DOI":"10.1097\/BRS.0000000000003518","article-title":"Does augmented reality navigation increase pedicle screw density compared to free-hand technique in deformity surgery? single surgeon case series of 44 patients","volume":"45","author":"E Edstr\u00f6m","year":"2020","journal-title":"Spine"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1007\/s00586-012-2509-3","article-title":"CT-navigation versus fluoroscopy-guided placement of pedicle screws at the thoracolumbar spine: single center experience of 4,500 screws","volume":"22","author":"A Waschke","year":"2013","journal-title":"Eur Spine J"},{"issue":"13","key":"ref3","doi-asserted-by":"crossref","first-page":"824","DOI":"10.21037\/atm-20-1106","article-title":"Accuracy of robot-assisted versus conventional freehand pedicle screw placement in spine surgery: a systematic review and meta-analysis of randomized controlled trials","volume":"8","author":"Y N Peng","year":"2020","journal-title":"Ann Transl Med"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1590\/1413-785220182606180635","article-title":"Accuracy of pedicle screw insertion: a comparison between fluoroscopic guidance and navigation techniques","volume":"26","author":"R PO Bilhar","year":"2018","journal-title":"Acta Ortop Bras"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1186\/s12891-021-04339-w","article-title":"Augmented reality in the operating room: a clinical feasibility study","volume":"22","author":"C Dennler","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"94","DOI":"10.21037\/atm-20-1132","article-title":"Current innovation in virtual and augmented reality in spine surgery","volume":"9","author":"F J Yuk","year":"2021","journal-title":"Ann Transl Med"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"351","DOI":"10.3171\/2021.2.SPINE202097","article-title":"Clinical accuracy and initial experience with augmented reality-assisted pedicle screw placement: the first 205 screws","volume":"36","author":"A Liu","year":"2021","journal-title":"J Neurosurg Spine"},{"key":"ref8","first-page":"1","article-title":"Percutaneous placement of lumbar pedicle screws via intraoperative CT image-based augmented reality-guided technology","author":"H Liu","year":"2019","journal-title":"J Neurosurg Spine"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"e1449","DOI":"10.1016\/j.wneu.2019.03.118","article-title":"Workflow caveats in augmented reality-assisted pedicle instrumentation: cadaver lab","volume":"126","author":"T M Urakov","year":"2019","journal-title":"World Neurosurg"},{"issue":"21","key":"ref10","doi-asserted-by":"crossref","first-page":"E1303","DOI":"10.1097\/BRS.0000000000001830","article-title":"Surgical navigation technology based on augmented reality and integrated 3D intraoperative imaging: a spine cadaveric feasibility and accuracy study","volume":"41","author":"A Elmi-Terander","year":"2016","journal-title":"Spine"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1007\/s11548-017-1652-z","article-title":"Augmented reality surgical navigation with ultrasound-assisted registration for pedicle screw placement: a pilot study","volume":"12","author":"L Ma","year":"2017","journal-title":"Int J 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Gertzbein","year":"1990","journal-title":"Spine"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.3171\/2021.5.FOCUS21209","article-title":"Real-time navigation guidance with intraoperative CT imaging for pedicle screw placement using an augmented reality head-mounted display: a proof-of-concept study","volume":"51","author":"D S Yanni","year":"2021","journal-title":"Neurosurg Focus"},{"issue":"06","key":"ref16","first-page":"937","article-title":"Augmented reality supported cervical transpedicular fixation on 3D-printed vertebrae model: an experimental education study","volume":"30","author":"M G Boyaci","year":"2020","journal-title":"Turk Neurosurg"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s11548-018-1814-7","article-title":"Head-mounted display augmented reality to guide pedicle screw placement utilizing computed tomography","volume":"14","author":"J T Gibby","year":"2019","journal-title":"Int J CARS"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.spinee.2019.10.012","article-title":"Augmented reality navigation for spinal pedicle screw instrumentation using intraoperative 3D imaging","volume":"20","author":"F M\u00fcller","year":"2020","journal-title":"Spine J"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s13018-020-01690-x","article-title":"Augmented reality-based navigation increases precision of pedicle screw insertion","volume":"15","author":"C Dennler","year":"2020","journal-title":"J Orthop Surg Res"}],"container-title":["Journal of Neurological Surgery Part A: Central European 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