Role of Visuohaptic Surgical Training Simulator in Resident Education of Orthopedic Surgery

World Neurosurg. 2018 Mar:111:e98-e104. doi: 10.1016/j.wneu.2017.12.015. Epub 2017 Dec 15.

Abstract

Objective: We sought to assess the validity of a virtual surgical training system on lumbar pedicle screw placement for residents.

Methods: Ten inexperienced residents were randomly assigned to the simulation training (ST) group (n = 5) and control group (n = 5). The ST group performed the lumbar pedicle screw placement on the virtual surgical training system, and the control group was given an introductory teaching session before the cadaver test. A total of 8 adult fresh cadavers including 5 males and 3 females were collected and randomly allocated to the 2 groups. Each group performed the bilateral L1-L5 pedicle screw instrumentation in the cadaver specimens, respectively. Accuracy was assessed by computed tomography after instrumentation. The screw penetration rates, acceptable rates, and average screw penetration distance of the 2 groups were compared using statistical analysis.

Results: The screw penetration rate of the ST group (12.5%) was significantly lower than the control group (37.5%, P < 0.05). The screw acceptable rates in ST and control groups were 100% and 85%, respectively, with statistical differences between each other (P < 0.05). There was also a statistically significant difference of the average screw penetration distance between the ST (1.37 ± 0.62 mm) group and control group (2.42 ± 0.51 mm, P < 0.05).

Conclusions: The virtual surgery simulation with greater accuracy is superior to the traditional teaching methods in surgical training of pedicle screw placement and can be used as a promising alternative for training of neurosurgical procedures.

Keywords: Cadaver study; Lumbar spine; Pedicle screw placement; Virtual reality.

MeSH terms

  • Clinical Competence
  • Feedback, Sensory
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Internship and Residency*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery*
  • Male
  • Models, Biological
  • Orthopedic Procedures / education
  • Orthopedic Surgeons / education*
  • Orthopedics / education
  • Pedicle Screws*
  • Random Allocation
  • Simulation Training*
  • Tomography, X-Ray Computed
  • Touch Perception
  • User-Computer Interface
  • Virtual Reality*
  • Visual Perception