Integration of Virtual Reality Headsets into Endoscopic Spine Surgery: Insights from a Cadaveric Lab and Multicenter Surgeon Survey.

Introduction: Endoscopic spine surgery (ESS) presents advantages over traditional microscopic techniques but faces limitations in terms of field of view and depth perception. Virtual reality (VR) devices offer solutions by integrating real-time digital images into the surgical field, enabling magnification and teleproctoring. Methods: The study was conducted in two phases. In the first phase, 55 surgeons completed a pre-use questionnaire. In the second phase, 19 surgeons participated in cadaveric practical training using the device and completed a post-use survey. Data were analyzed using R software. Results: Following device use, surgeon confidence in magnification increased significantly (from 21% to 57%), with improved perception of image quality. Acceptance of teleproctoring rose from 33% to 94.7%. The device was considered superior to the operating microscope in both image quality and ergonomics. Conclusions: VR head-mounted devices enhance visualization in ESS, allow intraoperative access to imaging, and support remote guidance via teleproctoring. Their adoption may contribute to improved training, planning, and surgeon ergonomics. However, additional controlled studies are required to determine their effects on clinical outcomes and operative performance.