{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:12:33Z","timestamp":1791666753936,"version":"4.3.4"},"reference-count":48,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Recent advancements in spinal navigation methodologies, particularly augmented reality (AR) techniques, have significantly enhanced the precision of spinal instrumentation procedures. This study aimed to evaluate the efficacy of AR-assisted navigation in spinal instrumentation surgery for thoracolumbar scoliosis. Materials and Methods: This retrospective observational study included 10 patients with thoracolumbar scoliosis who met specific inclusion criteria and were recruited at a single medical center. Two neurosurgeons and one neuroradiologist used the Gertzbein\u2013Robbins scale (GRS) for radiological evaluation. Preoperative and postoperative Cobb angles were measured to assess the correction of scoliosis. Overall, 257 screws were placed using the AR-assisted navigation system during thoracic and lumbar spinal deformity surgeries. Results: Among the 257 screws, 197 were placed in the thoracic spine and 60 in the lumbar spine, achieving an overall instrumentation accuracy of 98%. The preoperative Cobb angle of 69.5 \u00b1 22.2\u00b0 significantly improved to 10.1 \u00b1 4.1\u00b0 postoperatively. Regarding first-attempt screw placement accuracy, 97.4% of the screws in the thoracic spine (graded as GRS A or B) and 100% in the lumbar spine were placed with precision. Five grade C thoracic screws were identified, one of which required re-instrumentation. Conclusions: The AR navigation technique substantially improved the precision of spinal deformity surgery, with a high screw placement accuracy rate and significant scoliosis correction. The benefits of reduced attention diversion and an intuitive surgical experience suggest that AR technology could significantly improve spinal surgery practices and training programs, indicating potential for broader applicability in the future.<\/jats:p>","DOI":"10.3390\/medicina61040576","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T13:48:20Z","timestamp":1742824100000},"page":"576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Augmented Reality in Scoliosis Correction Surgery: Efficiency and Accuracy in Pedicle Screw Instrumentation"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2887-6974","authenticated-orcid":false,"given":"Chia-Ning","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-6607","authenticated-orcid":false,"given":"Chi-Ruei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sian-Siang","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiung-Chyi","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Yuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2544-0400","authenticated-orcid":false,"given":"Chung-Hsin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2544-8181","authenticated-orcid":false,"given":"Meng-Yin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e850","DOI":"10.1016\/j.wneu.2018.05.116","article-title":"Accuracy of freehand pedicle screw placement in surgical correction of thoracolumbar kyphosis secondary to ankylosing spondylitis: A computed tomography investigation of 2314 consecutive screws","volume":"116","author":"Qian","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.3109\/17453674.2010.548032","article-title":"The rate of screw misplacement in segmental pedicle screw fixation in adolescent idiopathic scoliosis","volume":"82","author":"Ohlin","year":"2011","journal-title":"Acta Orthop."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/15563316211028595","article-title":"Augmented reality in spine surgery: A narrative review","volume":"17","author":"Hersh","year":"2021","journal-title":"HSS J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s00264-016-3353-6","article-title":"Incidence and risk factors for the misplacement of pedicle screws in scoliosis surgery assisted by O-arm navigation-analysis of a large series of one thousand, one hundred and forty five screws","volume":"41","author":"Jin","year":"2017","journal-title":"Int. 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