Clinical Report: Extended Reality Applications in Cranial and Spinal Neurosurgery

Overview

Extended reality (XR) technologies, including virtual, augmented, and mixed reality, have seen significant growth in neurosurgery over the past two decades. A bibliometric analysis of the top 100 cited articles reveals increasing research focus, particularly after 2015, with applications spanning cranial and spinal procedures and notable contributions from diverse global institutions.

Background

Extended reality (XR) encompasses virtual reality (VR), augmented reality (AR), and mixed reality (MR), offering immersive 3D imaging experiences that enhance neurosurgical navigation and training. XR complements traditional neuronavigation, improving precision in treating intracranial pathologies such as aneurysms and gliomas. Additionally, XR-based training enhances resident education by integrating anatomical visualization with haptic feedback, reducing surgical time and improving safety. Despite growing interest, comprehensive bibliometric analyses specifically targeting neurosurgical XR applications have been lacking until this study.

Data Highlights

Key Findings

• Significant increase in XR neurosurgery publications since 1998, with majority after 2015 (p<0.001).
• XR technologies improve precision in cranial procedures such as aneurysm and tumor surgeries.
• XR-based training enhances neurosurgical resident education by improving procedural memory and confidence.
• 40% of top-cited articles are open access, with an increasing trend over time (p<0.001).
• Most publications are original research (85%), indicating active investigation in the field.
• Research contributions come from 61 different journals and institutions, reflecting broad global interest.

Clinical Implications

The expanding use of XR in neurosurgery offers enhanced surgical navigation and training opportunities, potentially improving patient outcomes and surgical safety. Clinicians should consider integrating XR technologies into both operative planning and resident education to leverage these benefits. Awareness of the growing body of evidence and open access resources can facilitate adoption and collaboration.

Conclusion

Extended reality applications in neurosurgery have rapidly evolved, with increasing research supporting their utility in both cranial and spinal procedures. Continued investigation and integration of XR technologies hold promise for advancing neurosurgical practice and education.

References

1. Bibliometric Study of XR in Neurosurgery, 2023 -- A Bibliometric Study of Extended Reality Applications in Cranial and Spinal Neurosurgery