Examining the benefits of extended reality in neurosurgery: A systematic review |
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| Affiliation: | 1. Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY, USA;2. Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School & University Hospital, New Brunswick, NJ, USA;1. Division of Neurosurgery, Angers University Hospitals, Angers, France;2. Laboratory of Anatomy−Faculty of Medicine, Angers, France;3. CRCINA, UMR 1232 INSERM/CNRS, and EA7315 Team, Angers, France;4. Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Switzerland;1. Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra, New York, New York, USA;2. Rothman Orthopaedics Institute - Spine, New York, New York, USA;1. Department of Neurological Surgery, Lenox Hill Hospital/Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA;2. Rutgers Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, New Jersey, USA;2. Division of Neurosurgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia;3. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada;4. Department of Neurosurgery, National Neuroscience Institute (NNI), King Fahad Medical City (KFMC), Riyadh, Saudi Arabia;5. Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada;1. Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA;2. Duke University Human Simulation and Patient Safety Center, Durham, North Carolina, USA |
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| Abstract: | While well-established in other surgical subspecialties, the benefits of extended reality, consisting of virtual reality (VR), augmented reality (AR), and mixed reality (MR) technologies, remains underexplored in neurosurgery despite its increasing utilization. To address this gap, we conducted a systematic review of the effects of extended reality (XR) in neurosurgery with an emphasis on the perioperative period, to provide a guide for future clinical optimization. Seven primary electronic databases were screened following guidelines outlined by PRISMA and the Institute of Medicine. Reported data related to outcomes in the perioperative period and resident training were all examined, and a focused analysis of studies reporting controlled, clinical outcomes was completed. After removal of duplicates, 2548 studies were screened with 116 studies reporting measurable effects of XR in neurosurgery. The majority (82%) included cranial based applications related to tumor surgery with 34% showing improved resection rates and functional outcomes. A rise in high-quality studies was identified from 2017 to 2020 compared to all previous years (p = 0.004). Primary users of the technology were: 56% neurosurgeon (n = 65), 28% residents (n = 33) and 5% patients (n = 6). A final synthesis was conducted on 10 controlled studies reporting patient outcomes. XR technologies have demonstrated benefits in preoperative planning and multimodal neuronavigation especially for tumor surgery. However, few studies have reported patient outcomes in a controlled design demonstrating a need for higher quality data. XR platforms offer several advantages to improve patient outcomes and specifically, the patient experience for neurosurgery. |
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| Keywords: | Extended reality Augmented reality Virtual reality Mixed reality Neurosurgery Patient outcomes Patient experience |
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