Visualization, navigation, augmentation. The ever-changing perspective of the neurosurgeon

A. Boaro; F. Moscolo; A. Feletti; G.M.V. Polizzi; S. Nunes; F. Siddi; M.L.D. Broekman; F. Sala

Brain and Spine (Jan 2022)

Visualization, navigation, augmentation. The ever-changing perspective of the neurosurgeon

A. Boaro,
F. Moscolo,
A. Feletti,
G.M.V. Polizzi,
S. Nunes,
F. Siddi,
M.L.D. Broekman,
F. Sala

Affiliations

A. Boaro: Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Corresponding author. Piazzale A. Stefani, 1, 37126 Verona, Italy.
F. Moscolo: Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
A. Feletti: Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
G.M.V. Polizzi: Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
S. Nunes: Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
F. Siddi: Department of Neurosurgery, Haaglanden Medical Center, The Hague, Zuid-Holland, the Netherlands
M.L.D. Broekman: Department of Neurosurgery, Haaglanden Medical Center, The Hague, Zuid-Holland, the Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, Zuid-Holland, the Netherlands
F. Sala: Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy

Journal volume & issue: Vol. 2
p. 100926

Abstract

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Introduction: The evolution of neurosurgery coincides with the evolution of visualization and navigation. Augmented reality technologies, with their ability to bring digital information into the real environment, have the potential to provide a new, revolutionary perspective to the neurosurgeon. Research question: To provide an overview on the historical and technical aspects of visualization and navigation in neurosurgery, and to provide a systematic review on augmented reality (AR) applications in neurosurgery. Material and methods: We provided an overview on the main historical milestones and technical features of visualization and navigation tools in neurosurgery. We systematically searched PubMed and Scopus databases for AR applications in neurosurgery and specifically discussed their relationship with current visualization and navigation systems, as well as main limitations. Results: The evolution of visualization in neurosurgery is embodied by four magnification systems: surgical loupes, endoscope, surgical microscope and more recently the exoscope, each presenting independent features in terms of magnification capabilities, eye-hand coordination and the possibility to implement additional functions. In regard to navigation, two independent systems have been developed: the frame-based and the frame-less systems. The most frequent application setting for AR is brain surgery (71.6%), specifically neuro-oncology (36.2%) and microscope-based (29.2%), even though in the majority of cases AR applications presented their own visualization supports (66%). Discussion and conclusions: The evolution of visualization and navigation in neurosurgery allowed for the development of more precise instruments; the development and clinical validation of AR applications, have the potential to be the next breakthrough, making surgeries safer, as well as improving surgical experience and reducing costs.

Published in Brain and Spine

ISSN: 2772-5294 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.journals.elsevier.com/brain-and-spine

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