Inside an operating room at Rush University Medical Center, the neurosurgery team treats a patient’s degenerative spine condition with tiny surgical instruments through small incisions with the help of a robotic arm controlled by the surgeon. Images from a tool-tracking camera and real-time data are projected onto a monitor for the surgery team to check.
Neurosurgeon John O’Toole, MD, performs the procedure without taking his eyes off the patient or touching any screens or controls. During this surgery, O’Toole was the first in the world to use a new extended reality headset that projects crucial imaging and information into his field of vision in one integrated view.
“So instead of having to look away from the patient or the surgical field to view the imaging guidance, it's all contained in the same visual field for us,” he said.
Building on an innovative system
Spine surgery involves complex and delicate parts of the body and requires pinpoint precision. Image-guided navigation helps plan and track instruments and implants. Hand-tracking allows the surgeon to use hand gestures to navigate, to zoom in on views or rotate 3D models without touching a screen or controls.
The headset pairs with the image-guided navigation and robotics the Rush neurosurgery team has been using for several years: It moves the critically important views and information off the screen and into the surgeon’s direct line of sight.
“We’re very excited to have done the first-ever surgical case with the Globus XR technology,” he said. “We have been using the XR system on many different types of cases but particularly those requiring complex spinal reconstruction for degenerative deformity or spinal tumors.”
The system has wider applications, too.
“We're even more excited about using this technology in more complex cases,” O'Toole added. “For spine tumors, trauma or infections that can be more complicated from an anatomical standpoint, this kind of technology can assist us greatly.”
How it works
The headset looks similar to virtual reality goggles, but it merges crucial real-time images in multiple views to navigate spine surgery. The system's key features make this possible:
- Its heads-up display maintains a view of the patient while projecting 2-dimensional and 3-dimensional images.
- The visor has three panels: one to show the 2D views, another to show the 3D models, and one clear panel that provides a direct view to the patient.
- Three sets of cameras are built into the headset to track tools and hand gestures; a color camera is trained on the patient.
- The display offers multiple views of the instruments, and the 3D models or holograms, which help the surgeon guide the instruments’ paths and maintain alignment.
- The images are also projected on monitors that allow the surgical team to see what the surgeon sees.
While augmented reality technologies have been available for years, O’Toole said many have had limited use. This extended reality system brings together many applications.
“The most exciting part is how this technology facilitates the efficiency and safety of the surgeries that we do,” he said, “in an effort to benefit our patients who have complex spine conditions often requiring advanced surgical procedures.”
