Research


Step into the new dimension of spine surgery with


Augmented Reality Surgical Navigation technology

    As more and more spine surgeries are performed annually, it is our mission to help surgeons treat their patients better. Today many spine surgeons are already experiencing the confidence and precision that comes with performing complex spine cases in Philips cutting edge Hybrid OR. Now we are on a research journey to further innovate intra-operative navigation for complex open and minimally-invasive spine surgeries with our new Augmented Reality Surgical Navigation technology.
    augmented reality surgical navigation video

    Why push the limitations of navigation for complex spine procedures?


    Our Spine suite solution with XperCT cone-beam CT and large field-of-view 2D and 3D images is a perfect example, which offers remarkably detailed insights during each phase of a spine procedure. Building on that strong base and our intensive collaborations with medical professionals at the forefront of spine procedures, we are aiming to take image guidance technology to the next level of precision. Our latest advance opens up new possibilities in performing open and minimally-invasive spine procedures by bringing imaging and Augmented Reality Surgical Navigation together in one solution.

    How does Augmented Reality Surgical Navigation work?


    Combines 3D X-ray imaging and optical imaging in a unique augmented-reality view of the inside and outside of a patient
    philips surgical navigation
    philips surgical navigation

    Our new Augmented Reality Surgical Navigation technology is being developed to add additional capabilities to manage X-ray dose (1 in picture above). The technology uses high-resolution optical cameras integrated in the flat panel X-ray detector (2) to image the surface of the patient. It then combines the external view captured by the cameras, and the internal 3D view of the patient acquired by the X-ray system, to construct a 3D augmented-reality view of the patient’s external and internal anatomy (3). This real-time 3D view of the patient’s spine in relation to the planned path, aims to improve procedure planning, surgical tool navigation and implant accuracy, as well as reduce procedure times.

     

    The Augmented Reality Surgical Navigation technology has the following characteristics:
     

    • Displays 4 optical views of planned path on patient. Optical navigation technology reduces use of X-ray dose in the OR
    • Provides high-resolution 3D volume rendering from an acquired cone beam CT scan
    • Offers intra-operative 3D imaging for navigation and validation
    • Automatic patient motion compensation with non-invasive markers, eliminating use of invasive reference frame
    • Automatic device tracking to follow progression of the needle towards the pedicle

    First Clinical Investigation results using Augmented Reality Surgical Navigation Technology

    target icon
    The primary objective of this clinical investigation is to estimate the accuracy of pedicle screw placement using Augmented Reality Surgical Navigation Investigational Device
    hospital icon
    Karolinska University Hospital Stockholm in Sweden is the first in a series of global clinical studies
    patient icon

    20 Patients treated, of which 13 with Scoliosis

    • 13 Scoliosis
    • 3 Spondylolisthesis
    • 4 others
    screw icon

    253 screws placed with Surgical Navigation

    • 250 screws placed without intraoperative revision
    • 3 screws revised intraoperatively
    spine icon

    94% screw placement accuracy in difficult Spine deformity surgeries

    • 64% grade 0: Screws perfectly in pedicle
    • 30% grade 1: 0-1 mm breach of cortical wall
    • 6% grade 2: 13/15 screws were larger than pedicle
    • No screws severely misplaced (grade 3)
    hours icon

    5 min

    Average screw placement time

    50% below 4 minutes

    xray icon

    Zero

    Device-related adverse events

    hours icon

    Zero

    X-ray during navigation

    • Radiation dose exposure for full procedure ranged from 0 to 1.1 μSv for operating surgeon
    • No post-operative CT as XperCT was used for clinical evaluation

    Related pre-clinical publications

    Augmented Reality on a C-arm system: A Preclinical Assessment for Percutaneous Needle Localization

    Surgical Navigation Technology Based on Augmented Reality and Integrated 3D Intraoperative Imaging

    A Spine Cadaveric Feasibility and Accuracy Study

    Feasibility and Accuracy of Thoracolumbar Minimally Invasive Pedicle Screw Placement With Augmented Reality Navigation Technology
    Radiation dose and image quality comparison during spine surgery with two different, intraoperative 3D imaging navigation systems
    Machine learning for automated 3-dimensional segmentation of the spine and suggested placement of pedicle screws based on intraoperative cone-beam computer tomography

    First clinical experience of Augmented Reality Surgical Navigation from Karolinska University Hospital, Sweden

    PHC Surgery Navigation Karolinska Testimonial