Department of Neurology and Neurosurgery, Neurosurgical Simulation and Artificial Intelligence Learning Centre, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada.
Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada.
Oper Neurosurg (Hagerstown). 2023 Oct 1;25(4):e196-e205. doi: 10.1227/ons.0000000000000813. Epub 2023 Jul 13.
Anterior cervical discectomy and fusion (ACDF) is among the most common spine procedures. The Sim-Ortho virtual reality simulator platform contains a validated ACDF simulated task for performance assessment. This study aims to develop a methodology to extract three-dimensional data and reconstruct and quantitate specific simulated disc tissues to generate novel metrics to analyze performance metrics of skilled and less skilled participants.
We used open-source platforms to develop a methodology to extract three-dimensional information from ACDF simulation data. Metrics generated included, efficiency index, disc volumes removed from defined regions, and rate of tissue removal from superficial, central, and deep disc regions. A pilot study was performed to assess the utility of this methodology to assess expertise during the ACDF simulated procedure.
The system outlined, extracts data allowing the development of a methodology which accurately reconstructs and quantitates 3-dimensional disc volumes. In the pilot study, data sets from 27 participants, divided into postresident, resident, and medical student groups, allowed assessment of multiple novel metrics, including efficiency index (surgical time spent in actively removing disc), where the postresident group spent 61.8% of their time compared with 53% and 30.2% for the resident and medical student groups, respectively ( P = .01). During the annulotomy component, the postresident group removed 47.4% more disc than the resident groups and 102% more than the medical student groups ( P = .03).
The methodology developed in this study generates novel surgical procedural metrics from 3-dimensional data generated by virtual reality simulators and can be used to assess surgical performance.
颈椎前路椎间盘切除融合术（ACDF）是最常见的脊柱手术之一。Sim-Ortho 虚拟现实模拟器平台包含经过验证的 ACDF 模拟任务，可用于绩效评估。本研究旨在开发一种从 ACDF 模拟数据中提取三维数据并重建和量化特定模拟椎间盘组织的方法，以生成新的指标来分析熟练和不熟练参与者的绩效指标。
我们使用开源平台开发了一种从 ACDF 模拟数据中提取三维信息的方法。生成的指标包括效率指数、从定义区域切除的椎间盘体积以及从表面、中央和深层椎间盘区域切除组织的速率。进行了一项初步研究，以评估该方法在评估 ACDF 模拟手术期间专业技能方面的效用。
所概述的系统提取了数据，允许开发一种可以准确重建和量化三维椎间盘体积的方法。在初步研究中，来自 27 名参与者的数据组分为住院后医生、住院医生和医学生组，允许评估多个新指标，包括效率指数（主动切除椎间盘的手术时间），其中住院后医生组花费 61.8%的时间，而住院医生和医学生组分别花费 53%和 30.2%（P=.01）。在环锯切开术部分，住院后医生组切除的椎间盘比住院医生组多 47.4%，比医学生组多 102%（P=.03）。
本研究中开发的方法从虚拟现实模拟器生成的三维数据中生成新的手术程序指标，并可用于评估手术性能。
