Variant anatomy of three-dimensional models of the brachial plexus in augmented and virtual reality

Modern surgical principles for repairing damaged nerves in brachial plexus injuries require individual and high-quality surgical planning based on the anatomy of a particular patient, as well as precise navigation during surgery. The aim of the study is to identify the correspondence of the variants of the brachial plexus structure on drugs and three– dimensional models for their use in augmented and virtual reality.

Material and methods. 44 three-dimensional digital and polymer models of the right brachial plexuses were created from 22 corpses of men and women aged 39–89 years. The accuracy of the reconstruction was verified by determining the structural variant of the brachial plexus in the preparations and three-dimensional models.

Results and discussion. The created three-dimensional digital and polymer models accurately reflect the structural variants of brachial plexus preparations, but not equally in the presence or absence of epineurium. At the epineural level, 7 variants of the structure of preparations and three–dimensional models of the brachial plexus were identified, and 4 at the perineural level. The identified variants differ in the number of spinal nerves and the structural features of the divisions of the middle and lower trunks. All three-dimensional digital models of the brachial plexus have been converted to the STL format and projected onto the surface of the human body using augmented reality and virtual reality to different depths of the digital twin.

Conclusions. The created database of 44 three-dimensional digital and polymer models of 7 variants of the brachial plexus structure at the epineural and 4 at the perineural levels, projecting them onto a specific patient or a digital twin, allows performing operations in augmented and virtual reality conditions.

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