• Anissa Saylany, Michael Spadola, Rachel Blue, Nikhil Sharma, Ali K Ozturk, and Jang Won Yoon.
• Department of Neurosurgery, Pennsylvania Hospital, Philadelphia, PA, USA. Electronic address: Anissa.saylany@pennmedicine.upenn.edu.
• World Neurosurg. 2020 Jun 1; 138: 369-373.

BackgroundIn a standard surgical operating room, advanced imaging is projected on a separate monitor screen away from the surgical field of view. This setup requires surgeons to repeatedly shift their attention between the operative field and a screen. Such movement may result in a disruption of focus that can extend surgical time, cause physical strain, and lead to surgical errors. A potential solution to this inefficiency in the surgical workflow is to use a heads-up display (HUD) to mirror what is being displayed. A HUD projects preoperative or intraoperative imaging over the surgical field, allowing surgeons to visualize both as they perform surgery.Case DescriptionWe performed a single-level arthroplasty for a patient with right-sided disc herniation at C6-7. A HUD was used by the lead surgeon to continuously view intraoperative X-rays without needing to repeatedly turn away from the surgical field while placing Caspar pins into the C6 and C7 vertebral bodies, and malleating trials and the artificial disc into the disc space.ConclusionsFollowing surgery, the patient experienced resolution of his preoperative right arm and hand paresthesia and regained full strength. This case describes the novel use of the Moverio BT-35E Smart Glasses (Epson Inc, Suwa, Japan) HUD during a spine procedure.Copyright © 2020 Elsevier Inc. All rights reserved.

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