How augmented reality is transforming spine surgery at Sarasota Memorial.
What if your surgeon had x-ray vision?
It’s long been the dream for surgeons and now it’s a reality, thanks to Sarasota Memorial’s new xvision-spine augmented reality surgical navigation system, or xvision, for short.
Created by Augmedics, the xvision system allows orthopedic surgeons like Dr. Ngoc Nguyen, who specializes in complex spine surgeries at Sarasota Memorial, to “see” through skin, muscle and even scar tissue as they perform delicate operations to correct deformity or revise previous surgeries.
“When you’re wearing those goggles,” says Dr. Nguyen, “it’s as if you have x-ray vision.”
What is Xvision?
The xvision-spine augmented reality surgical navigation system looks a bit like something out of science fiction. It's a fancy bit of headgear that the surgeon wears during surgery, which includes a transparent augmented reality display that the surgeon looks through.
With a CT scan providing the data, a built-in processor in the xvision headgear can project a fully detailed 3D model of the patient's spinal structure onto the surgeon's retina in real time. Combined with built-in tracking technology, when the surgeon looks down at the patient in front of them, it's as if they are looking through tissue directly to bone. From every angle, the surgeon can see what they're doing.
And for complex spine surgeries, says Dr. Nguyen, this is a tremendous leap forward.
"This 3D-projected image of the vertebra shows you in real time what the anatomy is and really takes any uncertainty out of the procedure," says Dr. Nguyen. "You know exactly where you're placing every screw."
Why is this a big deal?
When it comes to spine surgery, a lot of it comes down to the art of placing screws. These are drilled directly into the vertebra and serve as anchors for the rods that will accompany. And these screws must be put in exactly the right place, at exactly the right angle.
If mistakes are made, the consequences can range from nerve pain to something more severe, and require additional surgery (called a “revision”) to fix.
Before xvision, spine surgeons had to use a series of simple x-ray images to get an idea of what a patient's spine looked like as they lay on the operating table. Not only could this be a time-consuming procedure, but it left something to be desired in terms of accuracy. "We're putting down screws on a 2D image and hoping," says Dr. Nguyen. "And it doesn't account for rotation."
Rotational deformity, when the vertebra is twisted out of alignment around that central spinal column, presented a particular problem for x-ray imaging. Not so for a surgeon wearing an xvision headset, says Dr. Nguyen. "This technology gives you a live 3D image," he says. "And since I've worn it, I've not had any misplaced screws at all. You know exactly the angle that you need and you see it going in."
As an added bonus, he says, the process remains in the surgeon’s actual hands, so they can feel if anything goes wrong during implantation, such as a screw skidding off the mark.
All told, Dr. Nguyen says, it’s a technological leap that makes spine surgeries faster, safer, more accurate and economical.
"Huge benefits to the patient and huge benefits to the hospital," he says. "This technology allows for, potentially, 100% accuracy, so I know I'm putting the screws in the right place and I can do it very quickly."
To read more about orthopedic surgery and spine care at Sarasota Memorial, click here.
To read more about Augmedics’ xvision-spine augmented reality surgical navigation system, click here.
Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH's in-house wordsmith, Lederer earned his Master's degree in Public Administration and Political Philosophy from Morehead State University, KY.