Learning retention of thoracic pedicle screw placement using a high-resolution augmented reality simulator with haptic feedback
51 neurosurgery fellows and residents were selected to complete a practice session and test session on the open pedicle screw placement module on the ImmersiveTouch simulator. In the practice session, each participant was given five minutes to practice pedicle screw placement, during which they were allowed a maximum of six trial screw placements. Participants were able to use fluoroscopy guidance as they practiced. Next, during the test session, participants were again allowed a maximum of six pedicle screw placements, but without fluoroscopy guidance. During both sessions, participants were provided landmark guides on the anatomy; accuracy was based on proximity to these guides.
Performance accuracy, measured by the average Euclidean distance deviation from the starting and ending landmark guides, was 27.58 mm +/- 15.08 mm during the practice session and 23.42 mm +/- 7.44 mm during the test session, indicating learning retention from the practice session to the test session. Failure rate, or the frequency with which a screw was not placed successfully into the pedicle, was 16.9% in the practice session and 12.5% in the test session, also indicated learning retention from the practice session. The results of the study indicate that the use of a high-fidelity AR simulator with haptic feedback is a realistic and viable surgical training method.
“The accuracy of virtual pedicle screw placement achieved by participants using our simulator is comparable to the accuracy reported in recent retrospective evaluations of such placements. This similarity suggests that [the simulator] faithfully represents the “real-life” conditions, an important validation point.”
Luciano, C.; Banerjee, P.P.; Bellotte, B., et al. Learning retention of thoracic pedicle screw placement using a high-resolution augmented reality simulator with haptic feedback. Neurosurgery. 2011 September; 69(Suppl OPERATIVE): ons14–ons19.