Artificial Intelligence-Augmented Reality Application for Enhancing Piriformis Muscle Injection Safety and Accuracy: A Prospective, Double-Blind, Randomized Controlled Trial

Alif Noeriyanto Rahman, Setiawan Setiawan, Herry Herman, Irma Ruslina Defi, Hamidie Ronald Daniel Ray, Florencia Wirawan, Tolga Ergönenç, Pranab Kumar, Fellice Occhigrossi, Arun Bhaskar

Abstract


Ultrasound-guided injection achieves high target accuracy but requires specialized training and dedicated imaging equipment. This study evaluated the non-inferiority of artificial intelligence/augmented reality (AI/AR)-guided piriformis injection compared with ultrasound guidance in terms of accuracy, safety, and procedural efficiency. In this prospective, double-blind, randomized controlled trial, 200 patients were randomized 1:1 to receive either AI/AR-guided injection using the novel Anterior Landmark-based Injection of Piriformis (ALIP) technique or ultrasound-guided injection. Target accuracy was 98% in the AI/AR group and 96% in the ultrasound group, which confirmed non-inferiority (p = 0.48). Procedures were significantly shorter with AI/AR than with ultrasound (5.1 ± 1.9 vs. 8.4 ± 3.0 minutes, p < 0.001). At 12 weeks, ≥50% pain reduction was achieved by 88% of patients in the AI/AR group and 86% in the ultrasound group. The AI/AR-guided ALIP technique showed non-inferior accuracy, better procedural efficiency, and possible cost savings. These findings suggest that AI/AR-guided piriformis injection could widen access to precision interventions, especially in clinical settings without specialized imaging equipment.

Keywords


ALIP Technique; Artificial Intelligence; Augmented Reality; Piriformis Syndrome; Ultrasound Guidance

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DOI: https://doi.org/10.17509/ijost.v11i3.107720

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