Can a Hand-Held Navigation Device Reduce Cognitive Load? A User-Centered Approach Evaluated by 18 Surgeons

Abstract

During spinal fusion surgery, the orientation of the pedicle screw in the right angle plays a crucial role for the outcome of the operation. Local separation of navigation information and the surgical situs, in combination with intricate visualizations, can limit the benefits of surgical navigation systems. The present study addresses these problems by proposing a hand-held navigation device (HND) for pedicle screw placement. The in-situ visualization of graphically reduced interfaces, and the simple integration of the device into the surgical work flow, allow the surgeon to position the tool while keeping sight of the anatomical target. 18 surgeons participated in a study comparing the HND to the state-of-the-art visualization on an external screen. Our approach revealed significant improvements in mental demand and overall cognitive load, measured using NASA-TLX (p< 0.05 ). Moreover, surgical time (One-Way ANOVA p< 0.001 ) and system usability (Kruskal-Wallis test p< 0.05 ) were significantly improved.