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

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

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.

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).

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.