Dr. Brian Fiani talks VR, hosting Metaverse spine seminar

Neurosurgeon Brian Fiani, DO, became a pioneer in the future of spine surgery education in December. As part of the Minimally Invasive Spine Symposium in New York, Dr. Fiani donned a virtual reality headset and welcomed participants across the world in a Metaverse spine surgery seminar.

The Metaverse, part of Facebook and Instagram’s parent company Meta, is a virtual reality space that can be accessed through wearable technology. In professional settings, the Metaverse can be used to create virtual meetings that mirror the experience of seeing people in a physical space.

For his sessions, Dr. Fiani of New York City-based Weill Cornell Medicine/NewYork-Presbyterian Hospital, worked with NonNocere, a German company using VR to decentralize medical education. The partnership was “a no-brainer” for him.

“This was the natural evolution by moving things to the Metaverse, where one can be in this virtual reality world with people from an infinite amount of countries anywhere on the planet and all meet in one location, especially for spine surgery where there’s a very international presence,” Dr. Fiani told Becker’s.

A week before the conference, Dr. Fiani said he practiced his sessions with a VR headset and hand controls, something that took time to master.  

“If you want to draw something on a whiteboard in the Metaverse auditorium, or if you want to do preoperative planning about the size and trajectory of your screws for spinal instrumentation, learning what buttons and how to place a screw and how to elongate the screw and change the size and shape was the biggest challenge.” 

Dr. Fiani’s presentations included four simulated surgeries: degenerative spine surgery, spinal tumor surgery, revision spine surgery and deformity spine surgery. He included CT and MRI scans, slideshows and a virtual anatomy lab. 

“What was cool about [the virtual lab] was when they built these constructed models for the anatomy portion, I could do things that I cannot do in the real world,” he said. “For example, in one case, there was significant compression on the spinal cord and I was able to select out the bone and the ligament in order to actually see the compressive reshaping of the spinal cord, and you would not otherwise be able to see such things without the help of that virtual reality software.”

About 50 people used virtual reality headsets to join Dr. Fiani in a virtual auditorium that included a 3D spine model that in real life would be about 30 feet tall. Another 20 watched the session live on a screen.

“The participants were in awe,” he said. “[They] enjoyed the audio-visual quality, which has haptic feedback as well. They enjoyed the lifelike spine anatomy models, the projection of the imported CT and MRI scans and the surgical simulation features. It was really fun because the surgeons were like children discovering new toys on Christmas morning.”

Looking ahead, Dr. Fiani has plans to stick with VR and is planning a spine conference that would take place entirely in the Metaverse. He said VR has potential to serve spine surgeons at all stages of their careers.

“The future for using virtual reality has immense educational benefits, including case presentations and grand rounds, particularly for surgical training programs such as residencies and fellowships,” he said. “But even for the more experienced surgeons, this type of software with virtual reality and Metaverse offers them the ability to practice surgeries repeatedly and even use new equipment to improve workflow and decrease operating time.”