78 - Augmented Reality Head-Mounted Displays Versus Robotic-Assisted Platforms in Thoracolumbar Spinal Trauma: A Case Series

Saturday, June 3, 2023

11:44 AM – 11:46 AM

Location: Salons 10-12

Co-Author(s)

MK

Michael Kann, BS

Washington University in St. Louis School of Medicine, United States
SB

Samuel N. Brehm, BSME

Washington University School of Medicine in St. Louis, United States
AC

Abigail Carey-Ewend, BS

Washington University School of Medicine in St. Louis, United States
MR

Miguel Ruiz Cardozo, MD, MPH

Postdoctoral fellow
Washington University in St. Louis
St. Louis, Missouri, United States
SS

Som P. Singh

KANSAS CITY, Missouri, United States
RL

Raj S. Lavadi, M.B.B.S.

Washington University School of Medicine in St. Louis, United States
KB

Karma Barot, MA, BA

Washington University School of Medicine in St. Louis
St. Louis, Missouri, United States
MO

Michael Olufawo, MBA

Washington University School of Medicine in St. Louis, United States
GT

Gabriel Trevino-Verastegui, PhD

Washington University School of Medicine in St. Louis, United States
Md

Matthew de la Paz, BS

Washington University School of Medicine in St. Louis, United States
AH

Ahmed Hanafy, BS

Washington University School of Medicine in St. Louis, United States
AY

Alexander T. Yahanda, MD, MPHS

Washington University School of Medicine, United States
AP

Alexander Perdomo-Pantoja, MD

Washington University School of Medicine in St. Louis, United States
JJ

Julio Jauregui, MD

Washington University School of Medicine in St. Louis, United States
MC

Magalie Cadieux, MD, MMSc

Washington University School of Medicine in St. Louis, United States
CM

Camilo Molina, MD

Assistant Professor of Neurological Surgery
Washington University School of Medicine in St. Louis, United States

Submitter(s)

MK

Michael Kann, BS

Washington University in St. Louis School of Medicine, United States

Presenting Author (Person doing the Podium Present(s)

TB

Tim Bui, BS

Medical Student
Washington University in St. Louis School of Medicine, United States

Disclosure(s):

Tim Bui, BS: No financial relationships to disclose

Introduction: Technological innovation in trauma medicine can improve the speed and accuracy of a physician’s care response while having a large influence on downstream patient outcomes. This is especially true in spine surgery, where significant neurologic sequalae can occur if prompt evaluation and intervention are not performed. Augmented reality head-mounted display (AR-HMD) is a novel technology that provides surgeons with a real-time, computed tomography-guided, 3-dimensional recapitulation of a patient’s spine anatomy. In this study, we compare the effectiveness of surgery with an AR-HMD versus robot-assisted surgery in surgical spine trauma using multiple perioperative and patient-reported outcome measures (PROMs).

Aims/

Objectives: To compare the perioperative and patient reported outcomes achieved by surgery with an AR-HMD versus robot-assisted surgery for surgical spine trauma cases.

Methods: We retrospectively reviewed patients with spine trauma that underwent pedicle screw placement surgery guided by AR-HMD or robot-assisted platforms at an academic tertiary care center between January 1, 2021 and January 30, 2022. Perioperative outcomes collected included the surgery time, blood loss, and length of hospital stay (LOS). Oswestry Disability Index (ODI) scores, Charlson Comorbidity Index (CCI) scores, and surgical invasiveness index (SII) scores were also collected. Clinical patient information was collected in Microsoft Excel and analyzed in SPSS.

Results: The AR-HMD operated cohort included 4 females and 3 males with a mean age of 65.57 years (57-81), BMI of 28.44 kg/m2 (20.47-38.90), CCI of 3.86 (1-7), and SII scores of 8.14 (4-13). Injuries were stratified into one-level (4), two-level (2), and three-level fractures (1). Intra-operatively, there was an average of 461.43 mL blood lost, 1.14 transfusion units used, and 460.43 minutes of operating time. The average LOS was 23.71 days, with two patients discharged home, one patient discharged to an intermediate care facility, two patients discharged to skilled nursing facilities, and two patients discharged to other rehabilitation facilities. The average 3-, 6-, and 12-month ODI scores were 14.25 (n=8), 15.40 (n=5), and 12.66 (n=3), respectively. Robot-assisted surgery was performed on 5 females and 8 males, with a mean age of 55.61 years (23-85), BMI of 27.12 kg/m2 (17.57-33.91), CCI of 3.77 (0-12), and SII score of 14.23 (6-33). Injury was stratified into one-level fracture (10), two-level fracture (2), and eleven-level fracture (1). Intra-operatively, there was a mean of 431.54 mL blood lost, 0.46 transfusion units used, and 330.61 minutes of operating time. The average LOS was 10.38 days, with nine patients discharged home, one patient discharged to a home health care, two patients discharged to other rehabilitation facilities, and one patient discharged to a skilled nursing facility. The average 3-, 6-, and 12-month ODI scores were 22.67 (n=9), 18.60 (n=5), and 29.50 (n=2), respectively. The only statistically significant difference found between the two cohorts was in SII scores (p=0.036).

Conclusions: Surgery performed under an AR-HMD yields similar perioperative outcomes and disability scores in patients presenting with spine trauma when compared to robot-assisted surgery. While further validation is needed with a larger cohort, this study provides insight into the potential replacement of robot-assisted surgery with AR-assisted surgery.