Usability of Graphical Visualizations on a Tool-Mounted Interface for Spine Surgery

Screw placement in the correct angular trajectory is one of the most intricate tasks during spinal fusion surgery. Due to the crucial role of pedicle screw placement for the outcome of the operation, spinal navigation has been introduced into the clinical routine. Despite its positive effects on the...

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Bibliographic Details
Published in:	Journal of imaging Vol. 7; no. 8; p. 159
Main Authors:	Schütz, Laura, Brendle, Caroline, Esteban, Javier, Krieg, Sandro M., Eck, Ulrich, Navab, Nassir
Format:	Journal Article
Language:	English
Published:	Basel MDPI AG 21-08-2021 MDPI
Subjects:	Back surgery Cameras Cognitive load Interfaces Kruskal-Wallis test Localization medical augmented reality Navigation systems pedicle screw placement Pedicle screws Projectors spine surgery Surgery Surgical apparatus & instruments Surgical instruments surgical navigation tool-mounted interface Usability Visualization Wearable computers
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Summary:	Screw placement in the correct angular trajectory is one of the most intricate tasks during spinal fusion surgery. Due to the crucial role of pedicle screw placement for the outcome of the operation, spinal navigation has been introduced into the clinical routine. Despite its positive effects on the precision and safety of the surgical procedure, local separation of the navigation information and the surgical site, combined with intricate visualizations, limit the benefits of the navigation systems. Instead of a tech-driven design, a focus on usability is required in new research approaches to enable advanced and effective visualizations. This work presents a new tool-mounted interface (TMI) for pedicle screw placement. By fixing a TMI onto the surgical instrument, physical de-coupling of the anatomical target and navigation information is resolved. A total of 18 surgeons participated in a usability study comparing the TMI to the state-of-the-art visualization on an external screen. With the usage of the TMI, significant improvements in system usability (Kruskal–Wallis test p < 0.05) were achieved. A significant reduction in mental demand and overall cognitive load, measured using a NASA-TLX (p < 0.05), were observed. Moreover, a general improvement in performance was shown by means of the surgical task time (one-way ANOVA p < 0.001).
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Current address: Boltzmannstrasse 3, 85748 Garching b. München, Germany. These authors contributed equally to this work.
ISSN:	2313-433X 2313-433X
DOI:	10.3390/jimaging7080159