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Updated: Jul 3, 2025

Simultaneous Application of Transcranial Direct Current Stimulation during Virtual Reality Exposure
Published on: January 18, 2021
Development and Evaluation of a Virtual Reality Simulator for Spinal Cord Stimulation: A Randomized Controlled Trial
Ji Yeong Kim1, Yookyung Jang2, Eun Jang Yoon1
1Department of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Purpose:
The aim of this prospective study was to develop a virtual reality simulator (VRS) for spinal cord stimulation (SCS) trials and establish its effectiveness.
Methods:
We developed a VRS for SCS training by integrating patient imaging data analytics, creating artificial X-ray images, and using spatial alignment techniques and virtual reality technologies. The simulator was created by a physician with considerable experience in performing SCS, and can simulate the feeling of the procedure in a virtual environment. The efficacy of the simulator for SCS trials was assessed using a cohort of 20 novice trainees. The primary outcomes were duration of the procedure, checklist score, number of C-arm images captured, and overall trainee satisfaction.
Results:
The cohort that utilized the VRS had better Zwisch scale scores (P <0.001), completed the procedure in a shorter time (P <0.001), took fewer C-arm images (P <0.001), and reported better overall satisfaction (P = 0.011) than the cohort that did not.
Conclusion:
We developed a realistic and efficient VRS for educating novice trainees on SCS trials, thereby eliminating the risk of radiation exposure associated with cadaver training. The results of this study indicate that our VRS has potential as an instrumental resource that can be integrated into the educational framework for SCS trials.

