Grant: Project Grant

Approximately 20% of the 233,900 Canadians diagnosed with cancer this year will have spinal tumors or develop spinal metastases. In one quarter to one half of these people, the tumour presses on the spinal cord or nerve roots, causing severe pain, weakness, sensory problems, bowel or bladder dysfunction, or even paralysis. Of these, an estimated 2000-3700 patients have spine surgery each year to decrease pressure and relieve symptoms due to the tumors or metastases. Our goal is to improve outcome for these patients. While commercial surgical navigation systems help guide the surgeon (like a GPS), they have limited accuracy which can lead to errors and delays in surgery. Our innovative project will combine: •intra-operative ultrasound to achieve sub-mm accuracy for guidance with •augmented reality to provide 'superman x-ray vision' of critical, but hidden, structures for neuronavigation during surgery. These augmented views will be presented in the microscope, a tablet display or headset for the surgeon, and on a large monitor for the surgical team to follow and anticipate the next surgical steps. Ultrasound-based guidance and augmented reality will improve accuracy and reduce delays. The immediate benefits are two-fold: (1) augmented reality will improve intelligibility of the surgical plan during surgery by improving the efficiency of hand-eye coordination for surgery, enabling visualization of pathology that may be hidden under delicate tissues thus decreasing the risks of damaging healthy tissue and spinal nerves, and improving accuracy of separation surgery to enable tumor control by radiosurgery; (2) intra-operative ultrasound will increase accuracy of navigation so that preoperative image data and surgical plan are perfectly aligned with the patient's anatomy thus reducing operative time and the risk of morbidity of spine surgery. Furthermore a wide range of spinal interventions and other procedures will benefit from this innovative technology.