Neuronavigation has become an essential neurosurgical tool in pursuing minimal invasiveness and maximal safety, even though it has several technical limitations. Augmented reality (AR) neuronavigation is a significant advance, providing a real-time updated 3D virtual model of anatomical details, overlaid on the real surgical field. Currently, only a few AR systems have been tested in a clinical setting. The aim is to review such devices. We performed a PubMed search of reports restricted to human studies of in vivo applications of AR in any neurosurgical procedure using the search terms "Augmented reality" and "Neurosurgery." Eligibility assessment was performed independently by two reviewers in an unblinded standardized manner. The systems were qualitatively evaluated on the basis of the following: neurosurgical subspecialty of application, pathology of treated lesions and lesion locations, real data source, virtual data source, tracking modality, registration technique, visualization processing, display type, and perception location. Eighteen studies were included during the period 1996 to September 30, 2015. The AR systems were grouped by the real data source: microscope (8), hand- or head-held cameras (4), direct patient view (2), endoscope (1), and X-ray fluoroscopy (1) head-mounted display (1). A total of 195 lesions were treated: 75 (38.46 %) were neoplastic, 77 (39.48 %) neurovascular, and 1 (0.51 %) hydrocephalus, and 42 (21.53 %) were undetermined. Current literature confirms that AR is a reliable and versatile tool when performing minimally invasive approaches in a wide range of neurosurgical diseases, although prospective randomized studies are not yet available and technical improvements are needed.

Antonio Meola

Fabrizio Cutolo

Marina Carbone

Federico Cagnazzo

Mauro Ferrari

Vincenzo Ferrari

Neurosurgical review

NEUROSURGICAL REVIEW 的目标是为神经外科当前问题的全面审查提供一个论坛。每期最多包含三篇评论，反映一个主题（疾病或手术方法）的所有重要方面。专家小组在同一问题中的评论完善了该主题。通过每期提供一个主题的全面报道，NEUROSURGICAL REVIEW 将专业期刊的话题性与专着的深入处理相结合。也欢迎高质量的原创论文。

The goal of Neurosurgical Review is to provide a forum for a comprehensive review of current issues in neurosurgery. Each issue contains up to three reviews that cover all important aspects of a specific topic (such as a disease or surgical method). The comments from a panel of experts further enhance the discussion on the topic. By providing a thorough report on a single theme in each issue, Neurosurgical Review combines the topicality of a professional journal with the in-depth treatment of a monograph. High-quality original papers are also welcome.

《Neurosurgical Review》的目标是为神经外科领域的当前问题提供一个全面审查的论坛。每期最多包含三篇评论，涵盖一个特定主题（如疾病或手术方法）的所有重要方面。专家小组的评论将进一步完善该主题。通过每期提供一个主题的全面报道，《Neurosurgical Review》将专业期刊的广泛性与专著的深入分析相结合。同时，我们也欢迎高质量的原创论文。

Neurosurgical Review

Neurosurg Rev

Augmented reality in neurosurgery: a systematic review.

Current literature confirms that AR is a reliable and versatile tool when performing minimally invasive approaches in a wide range of neurosurgical diseases, although prospective randomized studies are not yet available and technical improvements are needed.

Category	Quartile
医学	3
医学, 临床神经病学	3
医学, 外科	3

Augmented reality in neurosurgery: a systematic review.

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