{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:39:07Z","timestamp":1790973547145,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Augmented reality mediated spine surgery is a novel technology for spine navigation. Benchmark cadaveric data have demonstrated high accuracy and precision leading to recent regulatory approval. Absence of respiratory motion in cadaveric studies may positively bias precision and accuracy results and analogous investigations are prudent in live clinical scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To report a technical note, accuracy, precision analysis of the first in-human deployment of this technology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A 78-yr-old female underwent an L4-S1 decompression, pedicle screw, and rod fixation for degenerative spine disease. Six pedicle screws were inserted via AR-HMD (xvision; Augmedics, Chicago, Illinois) navigation. Intraoperative computed tomography was used for navigation registration as well as implant accuracy and precision assessment. Clinical accuracy was graded per the Gertzbein-Robbins (GS) scale by an independent neuroradiologist. Technical precision was analyzed by comparing 3-dimensional (3D) (x, y, z) virtual implant vs real implant position coordinates and reported as linear (mm) and angular (\u00b0) deviation. Present data were compared to benchmark cadaveric data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Clinical accuracy (per the GS grading scale) was 100%. Technical precision analysis yielded a mean linear deviation of 2.07\u2009mm (95% CI: 1.62-2.52\u2009mm) and angular deviation of 2.41\u00b0 (95% CI: 1.57-3.25\u00b0). In comparison to prior cadaveric data (99.1%, 2.03\u00a0\u00b1\u00a00.99\u2009mm, 1.41\u00a0\u00b1\u00a00.61\u00b0; GS accuracy 3D linear and angular deviation, respectively), the present results were not significantly different (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&gt;\u00a0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The first in human deployment of the single Food and Drug Administration approved AR-HMD stereotactic spine navigation platform demonstrated clinical accuracy and technical precision of inserted hardware comparable to previously acquired cadaveric studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opaa398","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T21:30:05Z","timestamp":1609277405000},"page":"300-309","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":101,"title":["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"],"prefix":"10.1227","volume":"20","author":[{"given":"Camilo A","family":"Molina","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri"},{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M","family":"Sciubba","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob K","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Witham","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,3]]},"reference":[{"key":"bib1-20251027","first-page":"1","article-title":"Augmented reality-assisted pedicle screw insertion: a cadaveric proof-of-concept study","author":"Molina","year":"2019","journal-title":"J Neurosurg Spine"},{"key":"bib2-20251027","article-title":"A cadaveric precision and accuracy analysis of augmented reality mediated percutaneous pedicle implant insertion","author":"Molina","year":"2020","journal-title":"J Neurosurg Spine"},{"issue":"5","key":"bib3-20251027","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1049\/htl.2017.0062","article-title":"Quantifying attention shifts in augmented reality image-guided neurosurgery","volume":"4","author":"L\u00e9ger","year":"2017","journal-title":"Healthc Technol Lett"},{"issue":"4 Suppl 2","key":"bib5-20251027","first-page":"ONS361","article-title":"Minimally invasive transmuscular pedicle screw fixation of the thoracic and lumbar spine","volume":"59","author":"Ringel","year":"2006","journal-title":"Neurosurgery"},{"issue":"24","key":"bib6-20251027","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1097\/BRS.0b013e31825c05cd","article-title":"Percutaneous lumbar pedicle screw placement aided by computer-assisted fluoroscopy-based navigation: perioperative results of a prospective, comparative, multicenter study","volume":"37","author":"Yang","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"bib7-20251027","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/978-3-319-39546-3_42","article-title":"Does navigation improve pedicle screw placement accuracy? 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