Philips today announced a new breakthrough navigation technology meant for minimally invasive spine surgery for use in their “hybrid ORs.” The ORs themselves are specialized for procedures like spine surgery and contain an integrated fluoroscopy unit with 3D reconstructions like that seen in technologies like the O-arm.
The new navigation technology combines an optical tracking system with the CT-like functionality of the fluoro unit. This provides 3-dimensional navigation functionality much like that seen in Medtronic‘s Stealth station or Brainlab‘s large library of products.
The specific feature Philips is promoting is its “augmented reality” functionality. There are additional cameras attached to the fluoroscopy unit that combine images of the patient’s anatomy with the 3-dimensional imaging, outputting the result on a high resolution monitor. This theoretically gives the surgeon a better idea of where in the patient’s anatomy he should be initiating his pedicle screw placement while also taking advantage of the 3D navigation to ensure screw accuracy through the pedicle.
This technology doesn’t seem to involve any sort of head-mounted holographic display, but it doesn’t seem like a stretch to think that this could be easily adapted to work with something like the Microsoft HoloLens.
An early feasibility study demonstrates that when surgeons use this new technology on a cadaver during open surgery their accuracy increased to 85% as opposed to 64% with a freehand technique. It will be interesting to see in future studies if the AR functionality provides any benefit over conventional 3D navigation, if it provides any benefit for minimally invasive procedures, and finally, what results look like in actual patients as motion from breathing and general vibrations can sometimes make optical tracking more challenging.