LEARNING RETENTION OF THORACIC PEDICLE SCREW PLACEMENT USING A HIGH-RESOLUTION AUGMENTED REALITY SIMULATOR WITH HAPTIC FEEDBACK

OBJECTIVE:

To evaluate the learning retention of thoracic pedicle screw placement on a high-performance augmented reality and haptic technology workstation.

METHODS:

Fifty-one fellows and residents performed thoracic pedicle screw placement on the simulator. The virtual screws were drilled into a virtual patient’s thoracic spine derived from a computed tomography data set of a real patient.

RESULTS:

With a 12.5% failure rate, a two-proportion z-test yielded P= 0.08. For performance accuracy, an aggregate Euclidean distance deviation from entry landmark on the pedicle and a similar deviation from the target landmark in the vertebral body yielded P=0.04 from a two-sample t-test in which the rejected null hypothesis assumes no improvement in performance accuracy from the practice to the test sessions, and the alternative hypothesis assumes an improvement.

CONCLUSIONS:

The performance accuracy on the simulator was comparable to the accuracy reported in literature on recent retrospective evaluation of such placements. The failure rates indicated a minor drop from practice to test sessions, and also indicated a trend (P=0.08) towards learning retention resulting in improvement from practice to test sessions. The performance accuracy showed a 15% mean score improvement and over 50% reduction in standard deviation from practice to test. It showed evidence (P=0.04) of performance accuracy improvement from practice to test session.

Dwight Mann