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Background: Augmented reality (AR) technology is a new and promising option to advance and expand neurosurgical training because of recent advances in computer vision technology, improved AR software and hardware, and growing acceptance of this technology in clinical practice., Objective: To analyze the current status of AR use cases with the goal of envisioning future uses of AR in neurosurgical education., Methods: Articles applying to AR technology use in neurosurgical education were identified using PubMed, Google Scholar, and Web of Science databases following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses guidelines. Articles were included for review based on applicable content related to neurosurgical or neuroanatomy training. Assessment of literature quality was completed using standardized MERSQI scoring., Results: The systematic search identified 2648 unique articles. Of these, 12 studies met inclusion criteria after extensive review. The average MERSQI score was 10.2 (SD: 1.7). The most common AR platform identified in this study was the Microsoft Hololens. The primary goals of the studies were to improve technical skills and approaches to surgical planning or improve understanding of neuroanatomy., Conclusion: Augmented reality has emerged as a promising training tool in neurosurgery. This is demonstrated in the wide range of cases in technical training and anatomic education. It remains unclear how AR-based training compares directly with traditional training methods; however, AR shows great promise in the ability to further enhance and innovate neurosurgical education and training., (Copyright © Congress of Neurological Surgeons 2022. All rights reserved.)

Study Design: Feasibility study. Purpose: A phantom model was used to evaluate the accuracy of a novel augmented reality (AR) system for cervical screw placement. Overview of Literature: The use of navigation systems is becoming increasingly common in spine procedures. However, numerous factors limit the feasibility of regular and widespread use of navigation tools during spine surgery. AR is a new technology that has already demonstrated utility as a navigation tool during spine surgery. However, advancements in AR technology are needed to increase its adoption by the medical community. Methods: AR technology that uses a fiducial-less registration system was tested in a preclinical cervical spine phantom model study for accuracy during spinal screw placement. A three-dimensional reconstruction of the spine along with trajectory lines was superimposed onto the phantom model using an AR headset. Participants used the AR system to guide screw placement, and post-instrumentation scans were compared for accuracy assessment. Results: Twelve cervical screws were placed under AR guidance. All screws were placed in an acceptable anatomic position. The average distance error for the insertion point was 2.73±0.55 mm, whereas that for the endpoint was 2.71±0.69 mm. The average trajectory angle error for all insertions was 2.69°±0.59°. Conclusions: This feasibility study describes a novel registration approach that superimposes spinal anatomy and trajectories onto the surgeon's real-world view of the spine. These results demonstrate reasonable accuracy in the preclinical model. The results of this study demonstrate that this technology can assist with accurate screw placement. Further investigation using cadaveric and clinical models is warranted. [ABSTRACT FROM AUTHOR]

Management of chronic subdural hematoma (cSDH) poses unique challenges and can be fraught with complications. Understanding the spatial relationships of cSDH to adjacent brain tissue and skull topography is critical for successful surgical treatment. The aim of this report is to highlight the feasibility and efficacy of a novel augmented reality (AR) overlay tool for surgical planning with technical description of two surgical cases using AR for surgical management of cSDH. This report describes a fiducial-less AR system for surgical planning of surgical evacuation of cSDH. The AR system was used to superimpose 3D anatomy onto the patients head to provide image guidance during two cases of evacuation. Imaging demonstrated convexity cSDH. A 3D model of the patient's anatomy was created and registered onto the patients' heads using a novel AR system. Surgical evacuation of the cSDH was completed in each case with surgical planning assisted by AR overlay. [ABSTRACT FROM AUTHOR]

Glossopharyngeal neuralgia is a rare condition characterized by pain along the distribution of the glossopharyngeal nerve. Surgical approaches via microvascular decompression represent a common treatment strategy. For this procedure, an understanding of the location of the cranial nerve and the offending vasculature is critically important. A mixed reality system was used to register patient-specific 3D models onto the patients head for operative planning and anatomical visualization. A 58-year-old female presented to neurosurgery with severe right-sided facial, tongue, and jaw pain unresponsive to multiple conservative therapies including medication. T2-weighted MRI with FIESTA sequence demonstrated right posterior inferior communicating artery compression of the right glossopharyngeal nerve entry zone. An augmented reality system was used to visualize the patients' anatomy overlaid onto the patients' head. A microvascular decompression of Cranial Nerves IX and X was performed via a retrosigmoid approach. Patient obtained significant relief of preoperative pain symptoms without complications. [ABSTRACT FROM AUTHOR]