Rambani Rohit, Ward James, Viant Warren
Department of Computer Sciences, University of Hull, Hull, United Kingdom; Department of Orthopaedics, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom.
Department of Computer Sciences, University of Hull, Hull, United Kingdom.
J Surg Educ. 2014 Nov-Dec;71(6):805-9. doi: 10.1016/j.jsurg.2014.04.012. Epub 2014 Jun 23.
Simulation and surgical training has moved on since its inception during the end of the last century. The trainees are getting more exposed to computers and laboratory training in different subspecialties. More needs to be done in orthopedic simulation in spinal surgery.
To develop a training system for pedicle screw fixation and validate its effectiveness in a cohort of junior orthopedic trainees.
Fully simulated computer-navigated training system is used to train junior orthopedic trainees perform pedicle screw insertion in the lumbar spine. Real patient computed tomography scans are used to produce the real-time fluoroscopic images of the lumbar spine.
The training system was developed to simulate pedicle screw insertion in the lumbar spine. A total of 12 orthopedic senior house officers performed pedicle screw insertion in the lumbar spine before and after the training on training system. The results were assessed based on the scoring system, which included the amount of time taken, accuracy of pedicle screw insertion, and the number of exposures requested to complete the procedure.
The result shows a significant improvement in amount of time taken, accuracy of fixation, and the number of exposures after the training on simulator system. This was statistically significant using paired Student t test (p < 0.05).
Fully simulated computer-navigated training system is an efficient training tool for young orthopedic trainees. This system can be used to augment training in the operating room, and trainees acquire their skills in the comfort of their study room or in the training room in the hospital. The system has the potential to be used in various other orthopedic procedures for learning of technical skills in a manner aimed at ensuring a smooth escalation in task complexity leading to the better performance of procedures in the operating theater.
自上世纪末诞生以来，模拟和外科培训不断发展。学员们在不同亚专业中更多地接触到计算机和实验室培训。脊柱外科的骨科模拟仍有更多工作要做。
开发一种椎弓根螺钉固定训练系统，并在一群初级骨科受训人员中验证其有效性。
使用完全模拟的计算机导航训练系统，训练初级骨科受训人员在腰椎中进行椎弓根螺钉植入。利用真实患者的计算机断层扫描来生成腰椎的实时荧光透视图像。
开发该训练系统以模拟腰椎椎弓根螺钉植入。共有12名骨科高级住院医师在训练系统上进行训练前后，在腰椎中进行椎弓根螺钉植入。根据评分系统评估结果，评分系统包括完成手术所需的时间、椎弓根螺钉植入的准确性以及完成手术所需的曝光次数。
结果显示，在模拟器系统上进行训练后，完成手术所需的时间、固定的准确性以及曝光次数有显著改善。使用配对学生t检验，这具有统计学意义（p < 0.05）。
完全模拟的计算机导航训练系统是年轻骨科受训人员的一种有效训练工具。该系统可用于加强手术室培训，学员可以在舒适的书房或医院的训练室中掌握技能。该系统有可能用于各种其他骨科手术，以一种旨在确保任务复杂性平稳升级从而在手术室中更好地完成手术的方式来学习技术技能。
