Neurosurgeons at South Shore University Hospital (SSUH) have performed Suffolk County’s first-ever spinal surgery using an augmented reality navigation platform. The complex surgery, conducted on Aug. 16, involved the placement of spinal instrumentation with the Augmedics xvision Spine System in a patient who previously experienced complications from an earlier surgery.

The patient, 71-year-old Jeffrey Bargeski, had undergone a spine (T12 to L5 fusion) surgery 10 months prior that was complicated by postoperative infection. He continued to suffer from back pain, difficulty walking, and leg weakness. He also developed instrumentation issues with screws becoming dislodged from the bone and partial collapse of his spinal column causing narrowing of and pressure on his spinal cord.

After initially meeting Mr. Bargeski in April, Yike Jin, MD, the lead surgeon, prescribed medications to improve his bone quality and eliminate any lingering infection before proceeding with revision surgery. The surgery required an extensive decompression thoracolumbar spinal fusion from T8 to the pelvis—a highly complex procedure that spanned over eight hours.

“Revision surgeries are inherently more challenging because the anatomy is no longer normal after previous operations,” said Dr. Jin, the lead neurosurgeon, who collaborated with his partner, Ann Liu, MD, on the case. The Augmedics xvision Spine System utilizes a headset that projects 2D and 3D navigation into the surgeon’s line of sight, providing real-time visualization of the patient’s internal anatomy based on preoperative CT scans.

“The Augmedics xvision system was instrumental in guiding us through this revision surgery. In traditional navigation, surgeons rely on external monitors and must look away from the patient and surgical site while placing spinal instrumentation, but with Augmedics, the navigation and CT imaging is overlaid directly into our field of view” said Dr. Jin. “This allows us to keep our eyes on the patient to place screws more accurately, making the surgery safer.”

Although this was the first use of Augmedics in Suffolk County for spine surgery, Dr. Jin and Dr. Liu have been using the technology since 2020 during their time at Johns Hopkins Hospital. They also published the first case series of 205 augmented reality guided screws in 28 consecutive patients and found the system had a 98 percent accuracy.

“We are lucky to have been part of the first group of spine surgeons to use Augmedics and are excited to use it to South Shore University Hospital to help ensure that we provide the best spine care possible for our patients,” said Dr. Liu.

The technology not only improves precision but also has potential for built-in safety features, such as alerts when drilling too deeply, providing an additional layer of protection for patients.

“I foresee using this technology for all complex spinal fusion surgeries, particularly revisions, spine tumor surgeries, and cases involving abnormal anatomy,” said Daniel Sciubba, MD, senior vice president and chair of neurosurgery for Northwell. “It’s the next frontier in ensuring safety and precision in the operating room.”