Background Complex spine surgery requires a sound three-dimensional (3D) understanding of anatomy.

Objective Here, we report the preoperative use a of novel software (SpectoVR) that presents DICOM data as virtual 3D holograms.

Methods The software SpectoVR uses patient-specific DICOM data to render the anatomy as a hologram that is then viewed with a virtual reality (VR) headset. The surgeons used SpectoVR to prepare for complex surgeries.

Results Eight patients with the following diagnosis were presurgically studied with SpectoVR: (1) ankylosing spondylitis with fixed kyphotic cervical deformity treated with osteotomy reduction and cervicothoracic reconstruction; (2) persistent cervical foraminal stenosis after total disc replacement; (3) atlantoaxial osteoarthritis treated with C1–2 Magerl fixation; (4) adjacent segment degeneration with foraminal stenosis L5–S1; (5) C2–C4 chordoma; (6) spinal cord injury with rotational thoracolumbar fracture; (7) complex lumbopelvic deformity after prior hemipelvectomy for sarcoma and (8) atlantoaxial osteoarthritis and basilar impression in a patient with congenital craniosynostosis. Whereas VR did not omit the need for viewing the spine in the multiplane reconstruction mode, the authors feel that SpectoVR contributed to a better holistic understanding of the anatomy. Furthermore, positioning the spine like in the OR empowered the mental preparation for the surgery.

Conclusion Integrating SpectoVR in daily presurgical planning is feasible and appears to enhance the surgeon’s awareness of the case.