PURPOSE: This article and accompanying video provide a comprehensive workflow for incorporating headset-mounted augmented reality (AR) navigation for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). METHODS: Consecutive patients undergoing a single level MIS-TLIF with AR navigation for degenerative spondylolisthesis were analyzed between January 2023-2025. Demographic, intraoperative, and postoperative outcomes were collected. The AR workflow features a wireless headset with projection of intraoperative navigation in the surgical field. MIS pedicle screw placement, facetectomy, disc preparation, and contralateral arthrodesis are carried out percutaneously though single line of sight using navigated instruments. RESULT: , and mean CCI score was 2.1±1.5. The mean operative time from incision to closure for the entire cohort was 129±28 min, mean fluoroscopy time was 41±12 s, EBL was 51±33 ml, and the mean length of stay was 1.9±1.8 days. Two (9%) patients required reoperation at a mean 5 weeks. The AR protocol was safely implemented in all cases with improvement in back and leg pain and no persistent neurologic deficits at mean 163 day follow up. CONCLUSION: Headset-mounted AR navigation is a feasible and reproducible tool to provide visualization for MIS TLIF that can be successfully integrated into surgical workflow. In this initial case series, its use was associated with an acceptable early safety profile and consistent perioperative outcomes. However, given the limitations of this study, including its retrospective design and lack of a comparator cohort, further prospective and comparative studies are necessary to evaluate its impact on surgical efficiency, accuracy, and clinical outcomes.
Younus et al. (2026) studied this question.