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Spine
Original research
Image guided percutaneous spine procedures using an optical see-through head mounted display: proof of concept and rationale
  1. Gerard Deib1,
  2. Alex Johnson2,
  3. Mathias Unberath3,
  4. Kevin Yu3,
  5. Sebastian Andress3,
  6. Long Qian3,
  7. Gregory Osgood2,
  8. Nassir Navab3,
  9. Ferdinand Hui1,
  10. Philippe Gailloud1
  1. 1 Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
  2. 2 Department of Orthopedic Surgery, The Johns Hopkins Hospital, Baltimore, Maryland, USA
  3. 3 Computer Aided Medical Procedures, The Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr Gerard Deib, Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, Maryland, USA; gdeib1{at}jhmi.edu

Abstract

Background and purpose Optical see-through head mounted displays (OST-HMDs) offer a mixed reality (MixR) experience with unhindered procedural site visualization during procedures using high resolution radiographic imaging. This technical note describes our preliminary experience with percutaneous spine procedures utilizing OST-HMD as an alternative to traditional angiography suite monitors.

Methods MixR visualization was achieved using the Microsoft HoloLens system. Various spine procedures (vertebroplasty, kyphoplasty, and percutaneous discectomy) were performed on a lumbar spine phantom with commercially available devices. The HMD created a real time MixR environment by superimposing virtual posteroanterior and lateral views onto the interventionalist’s field of view. The procedures were filmed from the operator’s perspective. Videos were reviewed to assess whether key anatomic landmarks and materials were reliably visualized. Dosimetry and procedural times were recorded. The operator completed a questionnaire following each procedure, detailing benefits, limitations, and visualization mode preferences.

Results Percutaneous vertebroplasty, kyphoplasty, and discectomy procedures were successfully performed using OST-HMD image guidance on a lumbar spine phantom. Dosimetry and procedural time compared favorably with typical procedural times. Conventional and MixR visualization modes were equally effective in providing image guidance, with key anatomic landmarks and materials reliably visualized.

Conclusion This preliminary study demonstrates the feasibility of utilizing OST-HMDs for image guidance in interventional spine procedures. This novel visualization approach may serve as a valuable adjunct tool during minimally invasive percutaneous spine treatment.

  • spine
  • lumbosacral
  • intervention
  • device

https://doi.org/10.1136/neurintsurg-2017-013649

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    Footnotes

    • Contributors GD: conception and design, acquisition of the data, analysis and interpretation of the data,drafting article and critical revisions of the article, final approval of the article, and agreement to be 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. AJ and MU: conception and design, acquisition of the data, analysis and interpretation of the data,critical revisions of the article, final approval of the article, and agreement to be 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. KY: acquisition of the data, analysis and interpretation of the data, critical revisions of the article, final approval of the article, and agreement to be 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. SA and LQ: acquisition of the data, critical revisions of the article, final approval of the article, and agreement to be 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. GO, NN, FH, and PG: conception and design, critical revisions of the article, final approval of the article, and agreement to be 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.

    • Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.