Evaluating virtual reality as a tool for improving surgical planning in spinal tumors.

Purpose: Surgical planning is essential before the surgery, especially for spinal tumors resection. During the surgical planning, medical images are analyzed by surgeon on a standardized display mode using a computer. But this display mode has its limit in term of spatial perception of the anatomical structures. Our purpose in this study is to assess the impact of using another display mode like virtual reality (VR) on the surgical planning of spinal tumors resection by comparing VR with conventional computer-based visualization.

Methods: A user study was conducted with eight neurosurgeons, who planned six spinal tumor surgeries using both VR and computer visualization modalities. The evaluation focused on the perception of anatomical-functional information from medical images, the identification of anatomical structures, and the selection of surgical approaches represented by the number of anatomical structures traversed to attend the tumor. These parameters were assessed using objective questionnaires developed from a work domain analysis (WDA) already proved in brain surgery. We then adapted the WDA to spinal surgery.

Results: VR made it easier to perceive a greater number of anatomical-functional information compared to computer visualization. Surgeons identified a greater anatomical structure with VR compared to computer visualization. Furthermore, surgeons selected additional anatomical structures to be traversed to reach the tumor when using VR, leading to a more precise selection of surgical approaches. These findings can predict the added value of VR in helping surgical decision-making when planning surgery.

Conclusion: VR can be a promising tool for surgical planning by providing an immersive and interactive perspective that enhances understanding of anatomy. However, our finding is from an exploratory study, more clinical cases should be conducted to demonstrate its feasibility and reliability.