Registration made easy -- standalone orthopedic navigation with HoloLens

In surgical navigation, finding correspondence between preoperative plan and intraoperative anatomy, the so-called registration task, is imperative. One promising approach is to intraoperatively digitize anatomy and register it with the preoperative plan. State-of-the-art commercial navigation systems implement such approaches for pedicle screw placement in spinal fusion surgery. Although these systems improve surgical accuracy, they are not gold standard in clinical practice. Besides economical reasons, this may be due to their difficult integration into clinical workflows and unintuitive navigation feedback. Augmented Reality has the potential to overcome these limitations. Consequently, we propose a surgical navigation approach comprising intraoperative surface digitization for registration and intuitive holographic navigation for pedicle screw placement that runs entirely on the Microsoft HoloLens. Preliminary results from phantom experiments suggest that the method may meet clinical accuracy requirements.