Michael Pfandler1, Marc Lazarovici2, Philipp Stefan3, Patrick Wucherer3, Matthias Weigl4. 1. Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstrasse 1, Munich D-80336, Germany. Electronic address: michael.pfandler@med.uni-muenchen.de. 2. Institute for Emergency Medicine and Management in Medicine (INM), Ludwig-Maximilians-University Munich, Schillerstraße 53, Munich D-80336, Germany. 3. Computer Aided Medical Procedures, (CAMP), Computer Science Department (I-16), Technical University of Munich, Boltzmannstraße 3, Garching bei München D-85748, Germany. 4. Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstrasse 1, Munich D-80336, Germany.
Abstract
BACKGROUND CONTEXT: Virtual reality (VR)-based simulators offer numerous benefits and are very useful in assessing and training surgical skills. Virtual reality-based simulators are standard in some surgical subspecialties, but their actual use in spinal surgery remains unclear. Currently, only technical reviews of VR-based simulators are available for spinal surgery. PURPOSE: Thus, we performed a systematic review that examined the existing research on VR-based simulators in spinal procedures. We also assessed the quality of current studies evaluating VR-based training in spinal surgery. Moreover, we wanted to provide a guide for future studies evaluating VR-based simulators in this field. STUDY DESIGN AND SETTING: This is a systematic review of the current scientific literature regarding VR-based simulation in spinal surgery. METHODS: Five data sources were systematically searched to identify relevant peer-reviewed articles regarding virtual, mixed, or augmented reality-based simulators in spinal surgery. A qualitative data synthesis was performed with particular attention to evaluation approaches and outcomes. Additionally, all included studies were appraised for their quality using the Medical Education Research Study Quality Instrument (MERSQI) tool. RESULTS: The initial review identified 476 abstracts and 63 full texts were then assessed by two reviewers. Finally, 19 studies that examined simulators for the following procedures were selected: pedicle screw placement, vertebroplasty, posterior cervical laminectomy and foraminotomy, lumbar puncture, facet joint injection, and spinal needle insertion and placement. These studies had a low-to-medium methodological quality with a MERSQI mean score of 11.47 out of 18 (standard deviation=1.81). CONCLUSIONS: This review described the current state and applications of VR-based simulator training and assessment approaches in spinal procedures. Limitations, strengths, and future advancements of VR-based simulators for training and assessment in spinal surgery were explored. Higher-quality studies with patient-related outcome measures are needed. To establish further adaptation of VR-based simulators in spinal surgery, future evaluations need to improve the study quality, apply long-term study designs, and examine non-technical skills, as well as multidisciplinary team training.
BACKGROUND CONTEXT: Virtual reality (VR)-based simulators offer numerous benefits and are very useful in assessing and training surgical skills. Virtual reality-based simulators are standard in some surgical subspecialties, but their actual use in spinal surgery remains unclear. Currently, only technical reviews of VR-based simulators are available for spinal surgery. PURPOSE: Thus, we performed a systematic review that examined the existing research on VR-based simulators in spinal procedures. We also assessed the quality of current studies evaluating VR-based training in spinal surgery. Moreover, we wanted to provide a guide for future studies evaluating VR-based simulators in this field. STUDY DESIGN AND SETTING: This is a systematic review of the current scientific literature regarding VR-based simulation in spinal surgery. METHODS: Five data sources were systematically searched to identify relevant peer-reviewed articles regarding virtual, mixed, or augmented reality-based simulators in spinal surgery. A qualitative data synthesis was performed with particular attention to evaluation approaches and outcomes. Additionally, all included studies were appraised for their quality using the Medical Education Research Study Quality Instrument (MERSQI) tool. RESULTS: The initial review identified 476 abstracts and 63 full texts were then assessed by two reviewers. Finally, 19 studies that examined simulators for the following procedures were selected: pedicle screw placement, vertebroplasty, posterior cervical laminectomy and foraminotomy, lumbar puncture, facet joint injection, and spinal needle insertion and placement. These studies had a low-to-medium methodological quality with a MERSQI mean score of 11.47 out of 18 (standard deviation=1.81). CONCLUSIONS: This review described the current state and applications of VR-based simulator training and assessment approaches in spinal procedures. Limitations, strengths, and future advancements of VR-based simulators for training and assessment in spinal surgery were explored. Higher-quality studies with patient-related outcome measures are needed. To establish further adaptation of VR-based simulators in spinal surgery, future evaluations need to improve the study quality, apply long-term study designs, and examine non-technical skills, as well as multidisciplinary team training.
Authors: Jacob T Gibby; Samuel A Swenson; Steve Cvetko; Raj Rao; Ramin Javan Journal: Int J Comput Assist Radiol Surg Date: 2018-06-22 Impact factor: 2.924
Authors: Guy Waisbrod; Anne F Mannion; Támas F Fekete; Frank Kleinstueck; Deszö Jeszenszky; Daniel Haschtmann Journal: Eur Spine J Date: 2019-01-29 Impact factor: 3.134
Authors: P Stefan; M Pfandler; P Wucherer; S Habert; J Fürmetz; S Weidert; E Euler; U Eck; M Lazarovici; M Weigl; N Navab Journal: Unfallchirurg Date: 2018-04 Impact factor: 1.000