Accurate needle placement in spine interventions is critical for effective pain management, yet it depends on reliable identification of anatomical landmarks and careful trajectory planning. Conventional imaging guidance often relies both on CT and X-ray fluoroscopy, exposing patients and staff to high dose of radiation while providing limited real-time 3D feedback. We present an optical see-through augmented reality (OST-AR)-guided robotic system for spine procedures that provides in situ visualization of spinal structures to support needle trajectory planning. We integrate a cone-beam CT (CBCT)-derived 3D spine model which is co-registered with live ultrasound, enabling users to combine global anatomical context with local, real-time imaging. We evaluated the system in a phantom user study involving two representative spine procedures: facet joint injection and lumbar puncture. Sixteen participants performed insertions under two visualization conditions: conventional screen vs. AR. Results show that AR significantly reduces execution time and across-task placement error, while also improving usability, trust, and spatial understanding and lowering cognitive workload. These findings demonstrate the feasibility of AR-guided robotic ultrasound for spine interventions, highlighting its potential to enhance accuracy, efficiency, and user experience in image-guided procedures.

翻译：脊柱介入治疗中的精准穿刺对于有效镇痛至关重要，其依赖于可靠解剖标志识别和精细进针路径规划。传统影像引导多采用CT与X线透视联合，虽能提供实时三维反馈，但患者和医务人员会暴露于高剂量辐射。我们提出基于光学透视增强现实(OST-AR)引导的机器人系统用于脊柱手术，通过原位可视化脊柱结构支持进针路径规划。该系统集成锥束CT(CBCT)衍生的三维脊柱模型，并与实时超声共配准，使用户可融合全局解剖背景与局部实时影像。我们在仿体实验中评估了该系统在两种典型脊柱手术——关节突关节注射和腰椎穿刺中的表现。十六名受试者在两种可视化条件下实施穿刺：传统屏幕显示与增强现实。结果表明，增强现实显著缩短操作时间并降低跨任务定位误差，同时提升可用性、信任度、空间理解能力并减轻认知负荷。这些发现证实了增强现实引导机器人超声在脊柱介入中的可行性，凸显了其在提高图像引导手术的精准性、效率及用户体验方面的潜力。