Bohl Michael A, McBryan Sarah, Pais Danielle, Chang Steve W, Turner Jay D, Nakaji Peter, Kakarla U Kumar
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Oper Neurosurg (Hagerstown). 2020 Jul 1;19(1):98-106. doi: 10.1093/ons/opz326.
The Living Spine Model (LSM) is a three-dimensionally printed, surgical training platform developed by neurosurgical residents.
To evaluate the face and content validity of this model as a training tool for open posterior lumbar surgery.
Six surgeons with varying experience were asked to complete L3-5 pedicle screw fixation and L3-4 laminectomy on an LSM. Face validity was measured using a questionnaire, and content validity was measured using the National Aeronautics and Space Administration Task Load Index (NASA TLX) tests. Student's t-test was used to compare NASA TLX responses between junior and senior residents and to compare responses for live surgery vs simulated surgery on the LSM.
Junior residents took the longest time to complete the procedure, followed by senior residents and the attending surgeon (136.5, 98.3, and 84 min, respectively). The junior residents placed fewer successful pedicle screws (7/12) than senior residents and attending surgeon (18/18). All tested components of the model had excellent face validity, with scores ranging from 60% to 97%. Content validity testing demonstrated that the LSMs created overall workloads and specific types of work like live operating conditions.
The overall validity testing of the LSM demonstrates the high-potential utility of this model as a surgical education and testing platform for open posterior lumbar procedures. The LSM has great potential as an adjunct to surgical education, and it may become an increasingly important component of surgical resident curricula in the future.
活体脊柱模型（LSM）是一种由神经外科住院医师开发的三维打印手术训练平台。
评估该模型作为开放性后路腰椎手术训练工具的表面效度和内容效度。
邀请六位经验各异的外科医生在LSM上完成L3 - 5椎弓根螺钉固定和L3 - 4椎板切除术。使用问卷测量表面效度，使用美国国家航空航天局任务负荷指数（NASA TLX）测试测量内容效度。采用学生t检验比较初级和高级住院医师之间的NASA TLX反应，以及比较在LSM上进行的真实手术与模拟手术的反应。
初级住院医师完成手术的时间最长，其次是高级住院医师和主治医生（分别为136.5分钟、98.3分钟和84分钟）。初级住院医师成功置入的椎弓根螺钉（7/12）比高级住院医师和主治医生（18/18）少。模型的所有测试组件都具有出色的表面效度，得分范围为60%至97%。内容效度测试表明，LSM创造的总体工作量和特定类型的工作与真实手术条件相似。
LSM的整体效度测试表明，该模型作为开放性后路腰椎手术的外科教育和测试平台具有很高的潜在效用。LSM作为外科教育的辅助工具具有很大潜力，未来可能会成为外科住院医师课程中越来越重要的组成部分。
