Related Experiment Video
Updated: Sep 16, 2025
Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
Neurosurgical Resident Skill Development Using a Novel Simulator-Based Anterior Cervical Discectomy and Fusion
Faith C Robertson1, Corinna C Zygourakis2, Janet Y Wu2
1Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Background:
Simulation-based training is increasingly integrated into surgical education as a method to enhance technical skills in a safe and reproducible environment. This dual-institution pilot study - conducted within the neurosurgery residency programs at Massachusetts General Hospital and Stanford University - evaluates the feasibility and impact of integrating a three-dimensional printed anterior cervical discectomy and fusion (ACDF) simulator (UpSurgeon S.r.l), alongside spaced repetition learning in a novel simulator training curriculum.
Methods:
In the preliminary phase, 21 participants (n = 12 Massachusetts General Hospital, n = 9 Stanford University residents) performed a 1-level ACDF procedure on the simulator. Each procedure was timed, video recorded, and included an anatomy identification test and survey. Afterward, participants attended serial lab practice sessions using the ACDF simulators. In the final phase, participants repeated the ACDF procedure under the same conditions (timed, video recorded) as in the preliminary phase.
Results:
After completing the simulator training curriculum, average time from skin incision to retractor docking decreased by 29.6% (from 14:00 to 9:51 minutes, P = 0.018), cage placement time decreased by 70% (from 4:45 to 1:25 mins, P = 0.0058), and plate and screw placement time decreased by 27.9% (from 8:54 to 6:25 mins, P = 0.028). Anatomy assessment scores improved by an average of 1.6 points out of a maximum score of 10 (P = 0.008). Surveys indicated that residents agreed (66.7%) or strongly agreed (22.2%) that the simulator helped increase their neurosurgical skills and that may be considered for future curricular integration pending further validation (88.9%).
Conclusions:
Incorporating a three-dimensional-printed ACDF simulator alongside spaced repetition learning in a novel training curriculum suggests potential for improving procedural timing and anatomical knowledge in neurosurgical trainees.
