The future of science fiction is here, with Hospital for Special Surgery (HSS) Orthopedics at Stamford Health becoming the first facility in the tristate area to use an ultra-advanced computerized augmented-reality (AR) navigation technology for spine surgery.
HSS, Stamford Health Get on “X-Ray Vision” Bandwagon
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Harvinder Sandhu, M.D., M.B.A., co-chief of HSS Spine, is leading this effort, which, says HSS, essentially gives spine surgeons “x-ray vision” to see through tissue surrounding the spine.
The AR system, which allows for real-time positioning of surgical tools, features a headset which projects 3D data onto the surgeon’s retina.
“The spine system’s augmented reality platform enables ultraprecise alignment and positioning of spinal implants through enhanced visualization capabilities,” explained Dr. Sandhu. “The spinal implants can be placed with much less invasive surgery, as we don’t have to retract or move muscles and tissue to see a patient’s full spine.”
OTW asked how these new technologies specifically improve upon existing navigation and Dr. Sandhu explained, “Legacy navigation systems require the use of some form of a tower and video monitor system which results in,
- a fairly large footprint in the operating room, not conducive to ambulatory surgery center operating room formats and
- the surgeon to constantly direct attention away from the operative site.
By contrast, augmented reality systems:
- essentially require the footprint of a laptop computer and
- allow the surgeon to continuously operate while viewing an overlay screen in the headset.”
“Future iterations of this technology will allow the system to be built into loupe-type eyeglasses, a ‘wearable’ that has been familiar to surgeons for decades. Augmented reality technologies are also the most cost-effective navigation technologies. As surgeons become accustomed to delivering surgical care in a variety of settings (main hospital, regional ambulatory surgical centers), they do not need to be concerned with the availability of navigation in each and every site. The headsets are personalized and can travel with them.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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