Augmented Reality-Assisted Guide Plate Positioning in Lumbar Surgery Using Apple Vision Pro

We propose an AR system using Apple Vision Pro (AVP) to assess the accuracy of guide plate positioning in lumbar surgery. It leverages preoperative CT data and integrates fiducial marker tracking to automate the initial alignment of a virtual vertebra with the intraoperative anatomy. Additionally, we developed a graphical interface for the AVP platform, which allows manual adjustment of the pose and visualization of the virtual vertebra. The system was tested on 3D-printed lumbar phantoms, an ex vivo pig lumbar specimen, and two in vivo pig surgeries. Results demonstrated accurate guide plate alignment and superior visualization, validating the potential of AR systems in improving surgical precision in lumbar procedures.