Virtual reality force feedback spine surgery simulator training for pedicle screw placement: assessing the impact of seniority and spinal region

Abstract

Objective

To evaluate the efficacy of Virtual Reality Force Feedback Spine Surgery Training Simulators (VRFF-SSTS) in enhancing the skills of spinal pedicle screw placement (PSP) among orthopedic fellows in continuing medical education, and whether influenced by seniority and spinal location.

Methods

A multi-centered, cross-sectional study enrolled fellows from three tertiary care referral hospitals. Participants were categorized into three groups (A, B, and C) based on their post-graduation year (PGY), reflecting their hierarchical order of spine-surgical training: A (PGY1-5), B (PGY6-10), and C (> 10). Participants performed SPSP in the spinal saw bone model using the free-hand technique first, followed by training on IVRSS. The outcome before and after training was assessed on placement accuracy and overall competency through an objective rating scale.

Results

Sixty-four participants were included, with PGY A, B, and C 18 (28.1%),30 (46.9%), and 16 (25.0%) participants, respectively. Pre-training data indicated that screw placement accuracy improved with increasing seniority. The accuracy of lumbar pedicle screw placement surpassed that of atlantoaxial, subaxial cervical, and thoracic vertebrae. Post-training, there was a significant enhancement in screw placement accuracy across all groups compared to pre-training (p < 0.001), with no significant differences observed between seniority levels and spinal regions. Overall competency significantly improved following training, with PGY B and C fellows, who had prior experience with pedicle screw insertion, demonstrating more satisfactory performance.

Conclusion

VRFF-SSTS proves to be an invaluable tool for training surgical skills, capable of enhancing the accuracy of pedicle screw placement for junior spine surgeons within a constrained training period. However, the overall competency in pedicle screw placement remains superior among experienced surgeons compared to their junior counterparts, underscoring the ongoing importance of clinical practice.

Clinical trial number

Not applicable.