![]() This could be particularly helpful in MIS techniques with a narrow field of view such as the MIS-TLIF or in patients with severe degenerative changes and difficult anatomical conditions. Intraoperatively, this technique could help to identify the correct anatomical landmarks by highlighting them. However, advanced degenerative changes (osteophytes, facet arthropathy, severely collapsed disc space) caused inaccuracy of the automatized rendering function and needed manual correction of the outline. This function was in the available AR planning software already for different anatomical structures and the automatized rendering of the pedicle outlines worked reliably in our case series. In the future, the suggested landmarks may be identified automatically through digital rendering. The preoperative planning can be done when reviewing the images prior to the surgery and might take a user who is familiar with the workflow and the software less than 10 minutes. Since this limit, the comparability in our case series, we did not measure the preoperative planning time. Additionally, 4–5 cases were needed to get familiar with the functions of the AR software. In our experience, this required a learning curve to translate the position of the landmarks from 2D to the 3D view through the microscope in the OR. The evaluated version of the AR software allowed the preoperative planning only on the 2D CT scan slides and not on the 3D reconstructions. ![]()
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