Design, development, and evaluation of a method to create patient specific augmented reality model for accurate anatomical guidance and dynamic response during spine surgery.

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Conventional surgical guided procedures use a Multiview 2D screen to demonstrate the virtual anatomy of the patient while conveying surgical tool positioning in regard to patient anatomy in real-time. The benefits of this system are evident in its ability to provide augmented guidance to the surgeon regarding the relative positioning of the surgical tool in regard to non-exposed patient anatomy. However, such a format is not ideal. First, it represents the real 3-dimensional (3D) anatomy on a 2D screen outside of the surgical field of interest and forces the focus of the surgeon away from the patient. This creates a loss of direct vision towards the surgical field and increases the cognitive load on the surgeon. Second, such a system is very expensive making them seldom available outside academic hospital settings and not readily available to train early career surgeons. Third, the virtual models do not dynamically respond to anatomy-tool interactions as they are static in nature making the portrayed virtual geometry misleading as the procedure advances and patient anatomy altered. The present project seeks to rectify this unmet technological need by developing and evaluating a workflow and methodology to depict precise geometry of the spine using a mixed reality platform with accurate overlay between virtual and real-world geometry in the same field of view, inclusive of dynamic response to surgical maneuvers. Moreover, this timely and cost-effective technology will serve well both ends of the surgical training spectrum, from training residents on analogue and/or cadaveric models all the way to its use in the operating room by senior surgeons. This interdisciplinary and translational project has the strong opportunity to be disruptive to current medical training methods and surgical practices while clearing a path for others to follow suite in this sector via improved technical and regulatory standards correspondingly.