Virtual Reality Simulation for the Spine
The need to train surgeons to perform procedures on a model before they first operate on patients is not new. The popularity of surgical laboratory training is high; many surgical educators perceive an increasing role for formal laboratory training and for new technologies to do so. The reasons include the effect of limited duty hours on the traditional apprenticeship model of surgical training and the increased attention to patient safety.
This chapter describes a variety of surgical laboratory training methods, which can be included under the general umbrella of “simulation.” The range includes cadaver-based training with various enhancements, animal models – mostly cadaveric, artificial spine models, and mixed reality setups where an artificial or cadaver model is combined with computerized navigation or electronic sensors. The focus here is on the fully computerized end of the simulation spectrum. Some are simple image-only systems that help teach surgical anatomy and orientation, and others have taken the road of building a complete virtual reality simulation system. We describe the spine simulation developed in this partial virtual reality (or immersive simulation) so far and provide some insights into future directions. Each method of simulation has its uses and limitations, though the importance of a systematic curriculum is a uniting factor.
KeywordsSimulation Neurosurgery Spine Virtual reality Mixed reality Immersive Simulation Education in neurosurgery Resident training Mission Rehearsal Surgical laboratory
Video of open pedicle screw insertion. Using anatomical landmarks and virtual X-ray, the trainee drills a small area to prepare for pedicle finder insertion. The drilling provides tactile feedback including vibration, noise, and bone removal. Then the trainee uses a pedicle finder and X-ray guidance to reach the proper depth and use correct direction. The correct screw is selected and in this simulation, is inserted automatically following the pedicle finder-created path. (Used with permission of ImmersiveTouch) (MP4 10319 kb)
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