Turkish Neurosurgery
Augmented Reality Supported Cervical Transpedicular Fixation on 3D-Printed Vertebrae Model: An Experimental Education Study
Mehmet Gazi Boyacı1, Uğur Fidan 2, Ahmet Fatih Yuran2, Serhat Yıldızhan1, Furkan Kaya3, Ömer Kimsesiz4, Merve Özdil4, Akın Cengiz1, Adem Aslan 1
1Afyonkarahisar Health Sciences University , Neurosurgery, AFYONKARAHİSAR,
2Afyon Kocatepe University, Faculty of Engineering, Department of , Biomedical Engineering, AFYONKARAHİSAR,
3Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Radiology, AFYONKARAHİSAR,
4Afyonkarahisar Health Sciences University, Faculty of Medicine, Undergraduate Student Member, , AFYONKARAHİSAR,
DOI: 10.5137/1019-5149.JTN.30733-20.2

Aim:Transpedicular screw fixation is widely used because this method stabilises three columns of the vertebrae. However, upper cervical vertebrae implantation surgery is a difficult procedure. Applied instrumented surgery training includes animal and cadaver studies; however, every surgical residency programme cannot provide equal requirements. Augmented Reality (AR) is a technology that allows computer-generated virtual imagery information to be overlaid onto a live, direct or indirect, real-world environment in real time. We investigated the use of this technology as it contributes to spinal surgery education with the free-hand technique, and might reduce the error ratio.Material and Methods:Ten candidates, with anatomy education but no surgical experience, applied 36 pedicle screws with C2-C3 posterior transpedicular fixation technique to nine vertebrae models produced via a 3D printer.Results:Using AR to apply pedicle screws to the experimental vertebrae model increased the safety screw ratio significantly. In comparison of Grade 0 screws to other grades: 6/18 screws (33.3%) in the free-hand technique Group (n=18), and 14/18 screws (77.8%) in the AR Group (n=18), were measured for screw insertion safety ratios. The difference was statistically significant (p=0.018). The resemblance between our results and the results of previous studies researching supportive systems indicates our 3D printed vertebra model might be a helpful educational material.Conclusion:AR increases the safety ratio of cervical pedicle screw fixation significantly. The parameters investigated and used for the production of vertebrae models in this study can be used for experimental material production for future studies to investigate pedicle screw positioning.

Corresponding author : Mehmet Gazi Boyacı