Development of an Augmented Reality System Based on Marker Tracking for Robotic Assisted Minimally Invasive Spine Surgery.

Spine surgery is nowadays performed for a great number of spine pathologies; it is estimated that 4.83 million surgeries are carried out globally each year. This prevalence led to an evolution of spine surgery into an extremely specialized field, so that traditional open interventions to the spine were integrated and often replaced by minimally invasive approaches. Despite the several benefits associated to robotic minimally invasive surgeries (RMIS), loss of depth perception, reduced field of view and consequent difficulty in intraoperative identification of relevant anatomical structures are still unsolved issues. For these reasons, Augmented Reality (AR) was introduced to support the surgeon in surgical applications. However, even though the irruption of AR has promised breakthrough changes in surgery, its adoption was slower than expected as there are still usability hurdles. The objective of this work is to introduce a client software with marker-based optical tracking capabilities, included into a client-server architecture that uses protocols to enable real-time streaming over the network, providing desktop rendering power to the head mounted display (HMD). Results relative to the tracking are promising (Specificity = 0.98 ± 0.03; Precision = 0.94 ± 0.04; Dice = 0.80 ± 0.07) as well as real-time communication, which was successfully set.