Arizona surgeon uses augmented reality for state’s first-of-its-kind spinal surgery

PHOENIX — An Arizona surgeon is using technology on a spinal surgery that is the first of its kind in the state. 

Dr. Maziyar Kalani operated on a patient at the Mayo Clinic in Phoenix in May using augmented reality. 

Augmented reality-guided spine surgery allows surgeons to see a patient’s spine in 3D through the skin during minimally invasive spinal surgery.

While augmented reality has been used for several years for brain surgeries, Kalani recognized how beneficial it could be for his own work, which can include everything from removing a tumor to degenerative spine surgery to repair pinched nerves or arthritis. 

“Once you kind of push the boundary and try one of these things, it immediately becomes obvious what else you can apply it to,” Kalani told KTAR News 92.3 FM.

The technology also allows surgeons to wear specialized goggles that produce the augmented reality image.

“The imaging is really good at telling us how big it is before surgery, but sometimes you open the patient and you’re wondering if what you’re seeing fits on the preoperative imaging,” Kalani said. 

The augmented reality technology helps remove some of that guesswork. 

“You see in relation into that imaging how big it is on your screen, so you take out just what’s on your screen. Nothing more and hopefully nothing less,” Kalani said.

The images are not your standard black and white X-ray. By combining multiple images, doctors can now create multicolor 3-D models. 

Emma Royster, the XR Program Lead at Surgical Theater, helps create those images. 

“This basically has all of their images fused together as one. Right here, we’re highlighting the CT scan. You can see the bones, so that’s what you’re going to get from the CT scan and then we’ve used the MRIs to segment out further details,” Royster said.

With these 3-D images, doctors can rotate, zoom and even add and remove sections like bones, muscles and organs to get a better view — or make sure they do not cut anything they shouldn’t. 

“Before this, they were using their best judgment with the technology they have, and this gives them a more definitive idea of exactly how they’re going to be going into the spine and avoiding those critical structures,” she said.

Dr. Kalani said that doesn’t just help them plan for surgeries, it also helps them during one.

“You can take that 3D model, go into the OR (operating room) and using some of the microscope technology, exoscope technology, endoscope technology, overlay these three-dimensional models onto the actual person you’re operating on,” Kalani said.

He said that means an increase in the number of safer and less invasive surgeries. 

“We can really focus on doing minimally invasive surgery because we don’t have to see everything in the open to do the job well,” Kalani said.