Non-cadaveric spine surgery simulator training in neurosurgical residency

Paul Pöser MD , Robert Schenk MD , Hannah Miller MD , Ahmad Alghamdi MD , Adrien Lavalley MD , Katharina Tielking MD , Nitzan Nissimov MD , Anton Früh MD , Denny Chakkalakal MD , Victor Patsouris MD , Tarik Alp Sargut MD , Robert Mertens MD , Ran Xu MD , Peter Truckenmüller MD , Kiarash Ferdowssian MD , Judith Rösler MD , David Wasilewski MD , Claudius Jelgersma MD , Anna Roethe MD , Aminaa Sanchin MD , Julia Sophie Onken PD, MD
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Abstract

Background

Spine surgical training faces increasing challenges due to restricted working hours and greater sub specialization. Modern simulators offer a promising approach to teaching both simple and complex spinal procedures. This study evaluated the acceptance and efficacy of spine simulator training using a lumbar herniated disc model tested by 16 neurosurgical residents (PGY-1-6), and compared 3D and 2D teaching methods.

Methods

Sixteen residents utilized the Realists RealSpine L4/L5 disc simulator with both microscope and exoscope. A mixed-methods analysis assessed the efficacy and acceptance of the training. Six PGY-1 residents participated in a learning curve study, divided into exoscopic and microscopic cohorts. Each group watched a tutorial in either 3D or 2D, followed by 3 surgical sessions. Endpoints included surgical progress within 30 minutes and complication rates. Microsurgical skills and mental concepts were evaluated on a numeric Likert Scale.

Results

Participants rated the simulator training favorably, with a median score of 8/10 across 6 categories. The learning curve study showed a 30% improvement in microsurgical performance. The completion rate of herniated disc removal increased from 50% at T2 to 100% at T3 and T4. Significant improvement in mental concept was observed (p=.035), with slightly better consolidation in the exoscope group. Self-assessments revealed significantly improved skills across all participants.

Conclusions

Spine simulator training was well-received and resulted in improvements in both mental concept and microsurgical performance, with enhanced outcomes in the 3D teaching/exoscope group. This study supports the integration of spine simulators into spine surgical residency, particularly for early-stage training, to improve both cognitive and practical surgical skills.

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神经外科住院医师非尸体脊柱外科模拟器训练。
背景:脊柱外科培训面临越来越多的挑战,由于有限的工作时间和更大的亚专业化。现代模拟器提供了一种很有前途的方法来教授简单和复杂的脊柱手术。本研究通过16名神经外科住院医师(PGY-1-6)测试腰椎间盘突出症模型,评估脊柱模拟器训练的接受度和效果,并比较3D和2D教学方法。方法:16例住院医师使用realalists RealSpine L4/L5椎间盘模拟器,并结合显微镜和外窥镜。混合方法分析评估了培训的有效性和接受度。6名PGY-1住院患者参加了一项学习曲线研究,分为外窥镜组和显微镜组。每组都观看了3D或2D的教程,随后进行了3次手术。终点包括30分钟内的手术进展和并发症发生率。显微外科技术和心理概念以数值李克特量表进行评估。结果:参与者对模拟器训练的评价较好,6个类别的中位数得分为8/10。学习曲线研究显示显微手术的表现提高了30%。椎间盘突出清除的完成率从T2时的50%提高到T3和T4时的100%。观察到心理概念的显著改善(p= 0.035),外窥镜组的巩固效果略好。自我评估显示,所有参与者的技能都有了显著提高。结论:脊柱模拟器训练效果良好,在心理观念和显微手术表现方面均有改善,3D教学/外窥镜组的效果更好。本研究支持将脊柱模拟器整合到脊柱外科住院医师中,特别是用于早期培训,以提高认知和实际手术技能。
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CiteScore
1.80
自引率
0.00%
发文量
71
审稿时长
48 days
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