Journal of Clinical Medicine
Microscope-Integrated Augmented Reality-Assisted Navigation for C1–C2 Instrumentation: A Retrospective Single-Center Case Series
By Chi‐Ruei Li, Song-Ru Jhan, Hsi‐Kai Tsou and 7 others.
Abstract
Objective
Posterior C1–C2 instrumentation is technically demanding because of the complex osseous and vascular anatomy of the atlantoaxial region. This retrospective single-center case series aimed to describe the technical feasibility and observed screw-placement outcomes of a combined microscope-integrated augmented reality (AR)-assisted navigation workflow in patients with atlantoaxial instability.
Methods
Two neurosurgeons and one radiologist assessed screw placement accuracy on computed tomography (CT) images using the Gertzbein–Robbins classification, applying the Bredow modification for the cervical spine. Cortical breaches were classified as Grade 1, <1 mm; Grade 2, 1 to <2 mm; Grade 3, 2 to <3 mm; Grade 4, 3 to <4 mm; and Grade 5, ≥4 mm, or as transverse foramen obstruction exceeding half the screw diameter. Grades 1 and 2 were considered acceptable for screw insertion.