1. Non-cadaveric spine surgery simulator training in neurosurgical residency
- Author
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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, Peter Vajkoczy, MD, Thomas Picht, MD, and Julia Sophie Onken, PD, MD
- Subjects
Exoscope ,Microsurgery ,Neurosurgery ,Non-cadaveric spine surgery training ,Residency ,Orthopedic surgery ,RD701-811 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
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.
- Published
- 2024
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