• James Cho, Shervin Rahimpour, Andrew Cutler, C Rory Goodwin, Shivanand P Lad, and Patrick Codd.
• Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
• World Neurosurg. 2020 Jul 1; 139: 186-195.

ObjectiveAugmented reality (AR) is increasingly being explored as an adjunct to conventional neuronavigation systems. AR affords the ability to superimpose 3-dimensional images onto the real environment. A natural extension of this technology is to help guide neurosurgical planning and a means of stereotactic planning and guidance. Here we review the literature on the use of AR in neurosurgery with a focus on current technologies and limitations. Furthermore, we discuss this technology in the context of neurosurgical training as an educational tool.MethodsPubMed search was performed for "augmented reality and neurosurgery" and "mixed reality and neurosurgery" from 2010. A total of 113 articles written in the last 5 years were retrieved, and 39 were ultimately included in the systematic review.ResultsThe most common use of AR in neurosurgery was in cranial surgery (n = 26). Other uses included spine surgery (n = 9) and education (n = 2). Devices used for display of AR images varied as did image-to-patient registration methods and overall system accuracy.ConclusionsAlthough various AR systems have been successfully utilized across many neurosurgical disciplines, more research is needed to improve accuracy in registration and to assess whether AR-assisted surgery is safe and effective for widespread adoption.Copyright © 2020 Elsevier Inc. All rights reserved.

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