PT - JOURNAL ARTICLE AU - Jang W. Yoon AU - Michael Spadola AU - Rachel Blue AU - Anissa Saylany AU - Nikhil Sharma AU - Hasan S. Ahmad AU - Vivek Buch AU - Karthik Madhavan AU - H. Isaac Chen AU - Michael P. Steinmetz AU - William C. Welch AU - Neil R. Malhotra TI - Do-It-Yourself Augmented Reality Heads-Up Display (DIY AR-HUD): A Technical Note AID - 10.14444/8106 DP - 2021 Aug 01 TA - International Journal of Spine Surgery PG - 826--833 VI - 15 IP - 4 4099 - http://ijssurgery.com//content/15/4/826.short 4100 - http://ijssurgery.com//content/15/4/826.full SO - Int J Spine Surg2021 Aug 01; 15 AB - Background: We present a “Do-It-Yourself” method to build an affordable augmented reality heads-up display system (AR-HUD) capable of displaying intraoperative images. All components are commercially available products, which the surgeons may use in their own practice for educational and research purposes.Methods: Moverio BT 35-E smart glasses were connected to operating room imaging modalities (ie, fluoroscopy and 3D navigation platforms) via a high-definition multimedia interface (HDMI) converter, allowing for continuous high-definition video transmission. The addition of an HDMI transmitter-receiver makes the AR-HUD system wireless.Results: We used our AR-HUD system in 3 patients undergoing instrumented spinal fusion. AR-HUD projected fluoroscopy images onto the surgical field, eliminating shift of surgeon focus and procedure interruption, with only a 40- to 100-ms delay in transmission, which was not clinically impactful.Conclusions: An affordable AR-HUD capable of displaying real-time information into the surgeon's view can be easily designed, built, and tested in surgical practice. As wearable heads-up display technology continues to evolve rapidly, individual components presented here may be substituted to improve its functionality and usability. Surgeons are in a unique position to conduct clinical testing in the operating room environment to optimize the augmented reality system for surgical use.