AB089. SOH24AB_163. Accuracy of augmented reality assisted pedicle screw placement: a systematic review
Orthopaedic Session I

AB089. SOH24AB_163. Accuracy of augmented reality assisted pedicle screw placement: a systematic review

Neil Wu1, Salma Youssef1, Luke Turley2, Jake McDonnell3, Gráinne Cunniffe3, Seamus Morris3, Stacey Darwish3, Joseph Butler3

1School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin, Ireland; 2Department of Orthopaedics, Tallaght University Hospital, Tallaght, Dublin, Ireland; 3National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland

Background: Conventional freehand methods of pedicle screw placement are associated with significant complications due to close proximity to neural and vascular structures. Recent advances in augmented reality surgical navigation (ARSN) have led to its adoption into spine surgery. However, little is known regarding its overall accuracy. The purpose of this study is to delineate the overall accuracy of ARSN pedicle screw placement across various models.

Methods: A systematic review was conducted of Medline/PubMed, Cochrane and Embase Library databases according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Relevant data extracted included reports of pedicle screw placement accuracy and breaches, as defined by the Gertzbein-Robbins classification, in addition to deviation from pre-planned trajectory and entry point. Accuracy was defined as the summation of grade 0 and grade 1 events per the Gertzbein-Robbins classification.

Results: Twenty studies reported clinically accurate placed screws. The range of clinically accurate placed screws was 26.3–100%, with 2,095 screws (93.1%) being deemed clinically accurate. Furthermore, 5.4% (112/2,088) of screws were reported as grade two breaches, 1.6% (33/2,088) grade 3 breaches, 3.1% (29/926) medial breaches and 2.3% (21/926) lateral breaches. Mean linear deviation ranged from 1.3–5.99 mm, while mean angular/trajectory deviation ranged 1.6°–5.88°.

Conclusions: The results of this study highlight the overall accuracy of ARSN pedicle screw placement. However, further robust prospective studies are needed to accurately compare to conventional methods of pedicle screw placement.

Keywords: Accuracy; augmented reality; breaches; pedicle screw; spine surgery

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab089
Cite this abstract as: Wu N, Youssef S, Turley L, McDonnell J, Cunniffe G, Morris S, Darwish S, Butler J. AB089. SOH24AB_163. Accuracy of augmented reality assisted pedicle screw placement: a systematic review. Mesentery Peritoneum 2024;8:AB089.

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