Augmented and virtual reality in spine surgery, current applications and future potentials.

BACKGROUND CONTEXT: The field of artificial intelligence (AI) is rapidly advancing, especially with recent improvements in deep learning (DL) techniques. Augmented (AR) and virtual reality (VR) are finding their place in healthcare, and spine surgery is no exception. The unique capabilities and advantages of AR and VR devices include their low cost, flexible integration with other technologies, user-friendly features and their application in navigation systems, which makes them beneficial across different aspects of spine surgery. Despite the use of AR for pedicle screw placement, targeted cervical foraminotomy, bone biopsy, osteotomy planning, and percutaneous intervention, the current applications of AR and VR in spine surgery remain limited. PURPOSE: The primary goal of this study was to provide the spine surgeons and clinical researchers with the general information about the current applications, future potentials, and accessibility of AR and VR systems in spine surgery. STUDY DESIGN/SETTING: We reviewed titles of more than 250 journal papers from google scholar and PubMed with search words: augmented reality, virtual reality, spine surgery, and orthopaedic, out of which 89 related papers were selected for abstract review. Finally, full text of 67 papers were analyzed and reviewed. METHODS: The papers were divided into four groups: technological papers, applications in surgery, applications in spine education and training, and general application in orthopaedic. A team of two reviewers performed paper reviews and a thorough web search to ensure the most updated state of the art in each of four group is captured in the review. RESULTS: In this review we discuss the current state of the art in AR and VR hardware, their preoperative applications and surgical applications in spine surgery. Finally, we discuss the future potentials of AR and VR and their integration with AI, robotic surgery, gaming, and wearables. CONCLUSIONS: AR and VR are promising technologies that will soon become part of standard of care in spine surgery.

Mutual impact of clinically translatable near-infrared dyes on photoacoustic image contrast and in vitro photodynamic therapy efficacy (Erratum).

The erratum corrects an error in the y-axis labels of Fig. 4 and Fig. S2.

Mutual impact of clinically translatable near-infrared dyes on photoacoustic image contrast and in vitro photodynamic therapy efficacy.

Photodynamic therapy (PDT), a spatially localized phototoxic therapy that involves irradiation of a photosensitizer (PS) with specific wavelengths of light, has shown exceptional promise in impacting cancer treatment outcomes, particularly oral cancer. To reduce PDT outcome variability, attempts toward image-guided personalized PDT are being pursued by monitoring PS uptake either via fluorescence or photoacoustic imaging (PAI), a nonionizing modality dependent on optical absorption properties of the tissue. PAI-guided PDT requires a near-infrared contrast agent for deep tissue imaging with minimal photobleaching effect. We evaluate the impact of PDT agent, benzoporphyrin derivative (BPD), on PAI agent indocyanine green (ICG) and vice versa, given that they have different optical absorption properties and singlet oxygen quantum yields for PDT. Specifically, we demonstrate in two oral squamous cell carcinoma lines (FaDu and SCC4) that ICG has minimal effect on BPD PDT efficacy when irradiated with either a continuous or pulsed laser. Furthermore, the impact of BPD on ICG photodegradation was monitored with PAI in tissue-mimicking phantoms. These studies inform us that the combination of BPD and ICG can be utilized for PAI-guided PDT. However, researchers need to consider the photodegradation effects of ICG in the presence of BPD when designing their drug delivery strategies for PAI-guided PDT.