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Purpose This bibliometric analysis of the top 100 cited articles on extended reality (XR) in neurosurgery aimed to reveal trends in this research field. Gender differences in authorship and global distribution of the most-cited articles were also addressed. Methods A Web of Science electronic database search was conducted. The top 100 most-cited articles related to the scope of this review were retrieved and analyzed for trends in publications, journal characteristics, authorship, global distribution, study design, and focus areas. After a brief description of the top 100 publications, a comparative analysis between spinal and cranial publications was performed. Results From 2005, there was a significant increase in spinal neurosurgery publications with a focus on pedicle screw placement. Most articles were original research studies, with an emphasis on augmented reality (AR). In cranial neurosurgery, there was no notable increase in publications. There was an increase in studies assessing both AR and virtual reality (VR) research, with a notable emphasis on VR compared to AR. Education, surgical skills assessment, and surgical planning were more common themes in cranial studies compared to spinal studies. Female authorship was notably low in both groups, with no significant increase over time. The USA and Canada contributed most of the publications in the research field. Conclusions Research regarding the use of XR in neurosurgery increased significantly from 2005. Cranial research focused on VR and resident education while spinal research focused on AR and neuronavigation. Female authorship was underrepresented. North America provides most of the high-impact research in this area.
Purpose This bibliometric analysis of the top 100 cited articles on extended reality (XR) in neurosurgery aimed to reveal trends in this research field. Gender differences in authorship and global distribution of the most-cited articles were also addressed. Methods A Web of Science electronic database search was conducted. The top 100 most-cited articles related to the scope of this review were retrieved and analyzed for trends in publications, journal characteristics, authorship, global distribution, study design, and focus areas. After a brief description of the top 100 publications, a comparative analysis between spinal and cranial publications was performed. Results From 2005, there was a significant increase in spinal neurosurgery publications with a focus on pedicle screw placement. Most articles were original research studies, with an emphasis on augmented reality (AR). In cranial neurosurgery, there was no notable increase in publications. There was an increase in studies assessing both AR and virtual reality (VR) research, with a notable emphasis on VR compared to AR. Education, surgical skills assessment, and surgical planning were more common themes in cranial studies compared to spinal studies. Female authorship was notably low in both groups, with no significant increase over time. The USA and Canada contributed most of the publications in the research field. Conclusions Research regarding the use of XR in neurosurgery increased significantly from 2005. Cranial research focused on VR and resident education while spinal research focused on AR and neuronavigation. Female authorship was underrepresented. North America provides most of the high-impact research in this area.
External ventricular drain (EVD) insertion using the freehand technique is often associated with misplacements resulting in unfavorable outcomes. Augmented Reality (AR) has been increasingly used to complement conventional neuronavigation. The accuracy of AR guided EVD insertion has been investigated in several studies, on anthropomorphic phantoms, cadavers, and patients. This review aimed to assess the current knowledge and discuss potential benefits and challenges associated with AR guidance in EVD insertion. MEDLINE, EMBASE, and Web of Science were searched from inception to August 2023 for studies evaluating the accuracy of AR guidance for EVD insertion. Studies were screened for eligibility and accuracy data was extracted. The risk of bias was assessed using the Cochrane Risk of Bias Tool and the quality of evidence was assessed using the Newcastle-Ottawa-Scale. Accuracy was reported either as the average deviation from target or according to the Kakarla grading system. Of the 497 studies retrieved, 14 were included for analysis. All included studies were prospectively designed. Insertions were performed on anthropomorphic phantoms, cadavers, or patients, using several different AR devices and interfaces. Deviation from target ranged between 0.7 and 11.9 mm. Accuracy according to the Kakarla grading scale ranged between 82 and 96%. Accuracy was higher for AR compared to the freehand technique in all studies that had control groups. Current evidence demonstrates that AR is more accurate than free-hand technique for EVD insertion. However, studies are few, the technology developing, and there is a need for further studies on patients in relevant clinical settings.
Purpose: To develop an indigenous “Do it yourself” (DIY) three-dimensional (3D) ophthalmic surgery recording system and validate the perception of stereopsis using it. Methods: A cross-sectional survey of practicing ophthalmologists with post-postgraduation experience of at least 5 years for perception of stereopsis for three different surgeries was performed; cataract, retinal detachment, and intravitreal drug injection were recorded on DIY assembly, viewed on VRBOX and using laptop videos and pseudo 3 d videos as control. Results: The laptop videos and 3D VR Box videos received higher ratings for stereopsis than the pseudo 3D videos. The parameters that received significantly higher ratings on the 3D VR Box viewing were instrument’s position relative to the ocular surface in cataract surgery, anterior chamber depth during capsular staining, ophthalmic visco-surgical device injection, capsulorhexis, phaco tunnel depth, movement of nuclear fragments in the anterior chamber, and intra-ocular lens tilt in the capsular bag during cataract surgery (P < 0.05). In scleral buckling surgery, the parameters that were significantly rated higher on VR Box were globe contour, separation of the scleral plane from muscle, and explant plane (P < 0.05). Furthermore, the depth of the needle in the vitreous cavity while administering intravitreal drug injection was also rated significantly higher on VR Box (P < 0.05). However, the ratings for the depth of corneal incision, depth of scleral incision, overall color, and overall quality were not different statistically when compared between laptop and VR Box viewing. Conclusion: DIY 3D recording assembly offers a superior means of appreciating depth at various stages of cataract surgery, scleral buckling, and intravitreal drug injection when compared to laptop viewing and can serve as an effective tool for skill transfer.
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