Technical feasibility and safety of an intraoperative head-up display device during spine instrumentation

Background: The primary aim of this study was to determine the safety and feasibility of capturing and streaming neuronavigation images onto a head-up display during spine instrumentation. Methods: Using a novel device, neuronavigation images were captured and transferred wirelessly via a password-encrypted network to the head-up display. At the end of the procedure, the surgeons completed a survey to gather their opinions of the system. Results: Forty pedicle screws were placed using the head-up display. The average screw placement time was slightly shorter when the head-up display was used (4.13 min with vs. 4.86 min without). The post-procedure survey demonstrated that 79% of surgeon's responses were positive. Conclusion: A wearable head-up display can benefit current neuronavigation systems, but larger, outcomes-based trials are needed. Higher processing speed would allow streaming of higher resolution images. Along with an enlarged display, these may significantly improve utilization of this technology.