More than the Eye Can See: Hospital for Special Surgery First in NYS to Use Augmented Reality Guidance in Spine Surgery
An orthopedic surgeon at Hospital for Special Surgery (HSS) has performed the first augmented reality-guided spine surgery in New York State. Frank Cammisa, MD, chief emeritus of HSS Spine, performed a successful spinal decompression and fusion on a 28-year-old male patient with the first augmented reality (AR) system cleared by the FDA for navigation in spine surgery.
Augmented reality refers to digital information that is superimposed on a user’s view of the physical environment, providing images that can’t be seen with the naked eye. AR navigation in spine surgery superimposes 3D images of a patient’s anatomy onto the surgeon’s view of the operative field. Critical elements include a preoperative CT scan of the patient’s spine, which is used to plan and perform the surgery, and an augmented reality headset worn during the procedure.
The system Dr. Cammisa uses consists of a near-eye-display headset and the elements of a traditional navigation system. During surgery, it accurately determines the position of surgical instruments in real time and superimposes them on the patient's CT data. It has been likened to giving surgeons “x-ray vision,” enabling them to see structures underneath the skin.
“The technology allows us to visualize the patient’s 3D spinal anatomy during surgery to accurately guide instruments and place surgical implants, such as pedicle screws, while looking directly at the patient rather than at a separate computer screen,” Dr. Cammisa explained. “Improved control and visualization of the patient’s anatomy and critical structures can lead to a more precise, efficient surgery and can enhance safety."
He notes that the technology allows for a highly personalized surgery that can be used for most spinal procedures requiring the use of implants. People with degenerative disc disease, spinal stenosis and spinal deformities may be candidates.
Dr. Cammisa notes that as more surgeries are performed with the augmented reality system, patient follow-up and data collection will enable HSS researchers to compare AR to other technologies used in spine surgery to evaluate outcomes.
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 13th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2022-2023), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2022-2023). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a third consecutive year (2023). Founded in 1863, the Hospital has the lowest readmission rates in the nation for orthopedics, and among the lowest infection and complication rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 165 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.