Augmented Reality Navigated Sacral-Alar-Iliac Screw Insertion

ABSTRACT Background: Sacral-alar-iliac (SAI) screws are increasingly used for lumbo-pelvic fixation procedures. Insertion of SAI is technically challenging, and surgeons often rely on costly time-consuming navigation systems. We investigated the accuracy precision an augmented reality (AR)–based commercially available head-mounted device requiring minimal infrastructure. Methods: A pelvic sawbone model served to drill pilot holes 80 screw trajectories by 2 surgeons, randomly either freehand (FH) without any kind or with AR navigation. The number primary hole perforations, simulated perforation, axis/outer cortical wall distance, true sagittal cranio-caudal inclination angle (tSCCIA), axial medio-lateral angle, maximal length (MSL) were measured compared predefined optimal values. Results: In total, 1/40 (2.5%) AR-navigated showed a perforation before passing inferior gluteal line 24/40 (60%) FH (P < .05). differences between FH- AR-guided values significant tSCCIA ?10.8° ± 11.77° MSL ?65.29 15 mm vs 55.04 6.76 = .001). Conclusions: this study, additional anatomical information provided headset superimposed operative plan improved drilling in laboratory setting conventional technique. Further technical development validation studies currently being performed investigate potential clinical benefits AR-based approach described here. Level Evidence: 4.