UCI Health marks historic milestone in spine surgery

First AR-assisted endoscopic spinal fusion

Irvine, Calif.  — A UCI Health spine surgery team has successfully performed the world’s first endoscopic spinal fusion using augmented reality (AR) technology.

It is the first instance of AR being fully integrated with endoscopic spinal fusion, a technique that can mean reduced postoperative pain and faster recovery for patients compared with conventional open spine surgeries.

During the ultra-minimally invasive procedure, UCI Health spine surgeon Dr. Don Y. Park wore an AR headset with high-definition endoscopic video displaying alongside the patient’s MRI images and electronic medical record directly in his field of vision, allowing him to focus on the surgical field without the need to view multiple monitors or step away from the operating table.

“This AR-assisted, biportal endoscopic lumbar fusion allowed me to complete the entire endoscopic portion — from the decompression of the spinal nerves to completing the fusion — wearing an AR headset,” said Park, the founding director of the UCI Health Advanced Endoscopic and Outpatient Spine Program.

'Tremendous detail'

“It also allowed me to see in tremendous detail because of the endoscopic camera’s 4k resolution, and the large virtual video projection seen through the headset.”

Park performed the outpatient procedure on a 56-year-old man with severe lumbar spinal stenosis and unstable spondylolisthesis — a narrowing of the spinal canal in the lower back that puts pressure on the spinal nerves, combined with forward slippage of the vertebrae.

The patient suffered from chronic back pain and tingling in both legs that made walking more than a block difficult. After getting only partial relief from physical therapy and medication, he opted for endoscopic surgery.

Following a three-hour procedure on March 31, the patient was walking well and experiencing only mild pain at the incision sites when he was released the same day.

Pain eliminated

“Three months later, his pain is completely gone, along with his presurgery symptoms,” Park said. “He can exercise and walk long distances again.”

The implications for using AR in spine surgery are far-reaching.

“With the ability to overlay critical information in real time, AR enhances the surgeon’s situational awareness and workflow,” Park said.

The headset’s recording capabilities also makes it possible to create real-time surgical footage, which has the potential to revolutionize education for medical trainees.

Eventually, artificial intelligence programs may be combined with the AR headset to better visualize the spinal anatomy and improve the safety and efficiency of the procedures.

“As AR hardware evolves, we expect its integration in spine surgery to become more common, especially in endoscopic procedures to decompress delicate spinal nerves, where detailed visualization and ergonomics are crucial,” says Park.

Read more

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Dr. Don Y. Park is a board-certified, fellowship-trained UCI Health orthopedic surgeon highly skilled in advanced, ultra-minimally invasive techniques to treat most spinal conditions with less pain and faster recovery. He is one of about 50 U.S. surgeons performing these innovative spine procedures. To date, he has conducted more than 500 such surgeries and now teaches other doctors across the nation. He is internationally recognized as a key opinion leader in spinal endoscopy and lectures regularly throughout the world on the topic. He also has published peer-reviewed articles and textbook chapters on endoscopic and minimally invasive spine surgery.