Beyond the operating room: a simulator for sacroiliac screw insertion.

Area of Science:

• Orthopedic Surgery
• Medical Simulation
• Anatomical Visualization

Background:

• Current orthopedic screw insertion training relies on operating room experience, which is limited for uncommon procedures like minimally invasive sacroiliac (SI) screw insertion.
• The scarcity of training opportunities outside specialized centers highlights the need for alternative educational tools for SI screw procedures.

Purpose of the Study:

• To develop and implement a simulator for minimally invasive SI screw insertion.
• To leverage accurate 3-dimensional (3D) computed tomography (CT)-based visualization for anatomical training.
• To assess the simulator's realism and its impact on surgical trainees' understanding.

Main Methods:

• Development of a simulator using Tool Command Language and Amira 3D visualization software.
• Automatic segmentation of CT images to create 3D pelvic and upper sacral anatomical surfaces.
• Utilizing 3D inlet and outlet views for simulated guidewire and SI screw insertion.

Main Results:

• The simulator generated a realistic 3D representation of the pelvis.
• Users reported enhanced understanding of the SI screw insertion procedure after using the simulator.
• 3D reconstructions facilitated correlation between CT slices and radiographic views.

Conclusions:

• The developed simulator offers a valuable tool for training minimally invasive SI screw insertion.
• It enhances surgical trainees' familiarity with 3D pelvic visualization and procedural steps.
• Simulator-based training can effectively supplement traditional "learning by doing" methods.