Integrating Augmented Reality in Spine Surgery: Redefining Precision with New Technologies

De Jesus Encarnacion Ramirez, Manuel; Chmutin, Gennady; Nurmukhametov, Renat; Soto, Gervith Reyes; Kannan, Siddarth; Piavchenko, Gennadi; Nikolenko, Vladmir; Efe, Ibrahim E.; Romero, Alberto Ramírez; Mukengeshay, Jeff Ntalaja; Simfukwe, Keith; Mpoyi Cherubin, Tshiunza; Nicolosi, Federico; Sharif, Salman; Roa, Juan Carlos; Montemurro, Nicola

doi:10.3390/brainsci14070645

Cited by 7 publications

(1 citation statement)

References 77 publications

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“…Comparatively, our MRI-based study analyzes lumbar foraminal volumes across multiple levels from L1/L2 to L5/S1 in 500 healthy subjects, showcasing a progressive increase in volumes indicative of the biomechanical complexities of the lumbar spine ( Table 4 ). This MRI-based analysis offers detailed insights into the soft tissue components within the spinal foramina, a critical aspect for comprehensive diagnostic evaluations in complex spinal pathologies [ 66 , 67 ].…”

Section: Discussionmentioning

confidence: 99%

Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis—Part 2 of a Comprehensive Series

Nurmukhametov,

Encarnacion Ramirez,

Dosanov

et al. 2024

Medical Sciences

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Introduction: Lumbar foraminal stenosis (LFS) occurs primarily due to degenerative changes in older adults, affecting the spinal foramina and leading to nerve compression. Characterized by pain, numbness, and muscle weakness, LFS arises from structural changes in discs, joints, and ligaments, further complicated by factors like inflammation and spondylolisthesis. Diagnosis combines patient history, physical examination, and imaging, while management ranges from conservative treatment to surgical intervention, underscoring the need for a tailored approach. Materials and Methods: This multicenter study, conducted over six years at a tertiary hospital, analyzed the volumetric dimensions of lumbar foramina and their correlation with nerve structures in 500 patients without lumbar pathology. Utilizing high-resolution MRI with a standardized imaging protocol, eight experienced researchers independently reviewed the images for accurate measurements. The study emphasized quality control through the calibration of measurement tools, double data entry, validation checks, and comprehensive training for researchers. To ensure reliability, interobserver and intraobserver agreements were analyzed, with statistical significance determined by kappa statistics and the Student’s t-test. Efforts to minimize bias included blinding observers to patient information and employing broad inclusion criteria to mitigate referral and selection biases. The methodology and findings aim to enhance the understanding of normal lumbar foramina anatomy and its implications for diagnosing and treating lumbar conditions. Results: The study’s volumetric analysis of lumbar foramina in 500 patients showed a progressive increase in foraminal volume from the L1/L2 to the L5/S1 levels, with significant enlargement at L5/S1 indicating anatomical and biomechanical complexity in the lumbar spine. Lateral asymmetry suggested further exploration. High interobserver and intraobserver agreement levels (ICC values of 0.91 and 0.95, respectively) demonstrated the reliability and reproducibility of measurements. The patient cohort comprised 58% males and 42% females, highlighting a balanced gender distribution. These findings underscore the importance of understanding foraminal volume variations for lumbar spinal health and pathology. Conclusion: Our study significantly advances spinal research by quantifying lumbar foraminal volumes, revealing a clear increase from the L1/L2 to the L5/S1 levels, indicative of the spine’s adaptation to biomechanical stresses. This provides clinicians with a precise tool to differentiate between pathological narrowing and normal variations, enhancing the detection and treatment of lumbar foraminal stenosis. Despite limitations like its cross-sectional design, the strong agreement in measurements underscores the method’s reliability, encouraging future research to further explore these findings’ clinical implications.

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Section: Discussionmentioning

confidence: 99%

Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis—Part 2 of a Comprehensive Series

Nurmukhametov,

Encarnacion Ramirez,

Dosanov

et al. 2024

Medical Sciences

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Immersive Simulations in Surgical Training: Analyzing the Interplay Between Virtual and Real-World Environments

Lawson McLean,

Lawson McLean

2024

Simulation & Gaming

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Background The adoption of immersive simulations in surgical education marks a nuanced shift towards bridging virtual and real-world experiences. Introduced by Johan Huizinga and further explored by Edward Castronova, the “Magic Circle” concept serves as a metaphorical boundary within which the standard constraints of reality are temporarily lifted, allowing for the emergence of unique learning and interaction dynamics. This framework, while new to the field of surgical training, presents a theoretical potential for improving educational outcomes by merging simulated environments with actual surgical operations. Aim This study aims to critically assess the introduction of immersive simulations in surgical education, with a particular focus on the interplay between virtual scenarios and their real-world counterparts. It seeks to evaluate the potential of the Magic Circle as a novel conceptual framework for enhancing the educational journey within surgical disciplines. Method Through qualitative analysis, this research explores the application of immersive simulation technologies in surgical fields. It examines the Magic Circle concept's influence on these educational paradigms, especially regarding its effect on the efficiency of learning, the transferability of skills, and levels of learner engagement. Results This paper proposes that embedding immersive simulations within the Magic Circle framework could lead to improved understanding of surgical procedures and heightened acquisition of skills. This conceptualization suggests a promising avenue for enriching the educational matrix in surgical training, bridging theoretical knowledge with practical application through a novel lens. Recommendation The study advises a judicious integration of immersive simulation technologies within surgical training programs, guided by the principles of the Magic Circle. It calls for further empirical research to validate and refine this conceptual approach, with an emphasis on maximizing the utility of immersive learning tools, enhancing the effectiveness of skill transfer, and ensuring an equitable and effective educational experience for all surgical trainees.

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Pioneering Augmented and Mixed Reality in Cranial Surgery: The First Latin American Experience

Ramírez Romero,

Rodríguez Herrera,

Sánchez Cuellar

et al. 2024

Brain Sciences

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Introduction: Augmented reality (AR) and mixed reality (MR) technologies have revolutionized cranial neurosurgery by overlaying digital information onto the surgical field, enhancing visualization, precision, and training. These technologies enable the real-time integration of preoperative imaging data, aiding in better decision-making and reducing operative risks. Despite challenges such as cost and specialized training needs, AR and MR offer significant benefits, including improved surgical outcomes and personalized surgical plans based on individual patient anatomy. Materials and Methods: This study describes three intracranial surgeries using AR and MR technologies at Hospital Ángeles Universidad, Mexico City, in 2023. Surgeries were performed with VisAR software 3 version and Microsoft HoloLens 2, transforming DICOM images into 3D models. Preoperative MRI and CT scans facilitated planning, and radiopaque tags ensured accurate image registration during surgery. Postoperative outcomes were assessed through clinical and imaging follow-up. Results: Three intracranial surgeries were performed with AR and MR assistance, resulting in successful outcomes with minimal postoperative complications. Case 1 achieved 80% tumor resection, Case 2 achieved near-total tumor resection, and Case 3 achieved complete lesion resection. All patients experienced significant symptom relief and favorable recoveries, demonstrating the precision and effectiveness of AR and MR in cranial surgery. Conclusions: This study demonstrates the successful use of AR and MR in cranial surgery, enhancing precision and clinical outcomes. Despite challenges like training and costs, these technologies offer significant benefits. Future research should focus on long-term outcomes and broader applications to validate their efficacy and cost-effectiveness in neurosurgery.

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Integrating Augmented Reality in Spine Surgery: Redefining Precision with New Technologies

Cited by 7 publications

References 77 publications

Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis—Part 2 of a Comprehensive Series

Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis—Part 2 of a Comprehensive Series

Immersive Simulations in Surgical Training: Analyzing the Interplay Between Virtual and Real-World Environments

Pioneering Augmented and Mixed Reality in Cranial Surgery: The First Latin American Experience

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