• Sulaman Durrani, Chiduziem Onyedimma, Ryan Jarrah, Atiq Bhatti, Karim Rizwan Nathani, Archis R Bhandarkar, William Mualem, Abdul Karim Ghaith, Cameron Zamanian, Giorgos D Michalopoulos, A Yohan Alexander, Walter Jean, and Mohamad Bydon.
• Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
• World Neurosurg. 2022 Dec 1; 168: 190201190-201.

BackgroundIn this era of imagination and technological innovation, mixed reality systems such as virtual reality (VR) and augmented reality (AR) are contributing to a wide array of neurosurgical care, from the betterment of surgical planning and surgical comfort to novel treatments and improved resident education. These systems can augment procedures that require high-level dexterity such as minimally invasive surgery and tumor excisions, as well as peripheral and neurovascular surgery. We define and compare the technological features, indications, and characterized outcomes of VR and AR systems in the context of neurosurgery through a review of the literature to date. Moreover, this review discusses the limitations of VR and AR and includes an overview of the cost-effectiveness of each of these systems.MethodsAn extensive review of the literature on AR and VR was performed using PubMed, OVID Medline, and Embase from January 1, 2006 to April 2, 2022. Terms used for the search included AR, spinal surgery, VR, and neurosurgery.ResultsThe search yielded full-text English language-related articles regarding VR and AR application, limitations, and functional outcomes in neurosurgery. An initial set of 121 studies were screened and reviewed for content. Thirteen studies were included, which involved 162 patients, 550 screw placements, 58 phantom spines, and learning points from simulation training of 276 involved residents.ConclusionsThis literature review examines recent research into VR and AR applications in neurosurgical care. The literature establishes that there are technological features, indications, outcomes, limitations, and cost-effectiveness differences between these systems. Based on ongoing and evolving applications of the VR and AR systems, the innovative potential that they make available to the future of neurosurgical patient care makes clear the need for further studies to understand the nuances between their differing technological advances.Copyright © 2022 Elsevier Inc. All rights reserved.

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