Ueda Haruki, Inami Satoshi, Moridaira Hiroshi, Takahata Masahiko, Iimura Takuya, Tanaka Nobuki, Takada Satoshi, Kanto Tomoya, Doi Kazuo, Taneichi Hiroshi
Department of Orthopaedic Surgery, Dokkyo Medical University, 880, Kitakobayashi, Mibu, Shimotsuga, Tochigi, Japan.
Department of Orthopaedic Surgery, University of Yamanashi, Shimokato, Chuo, Yamanashi, 1110, Japan.
BMC Med Educ. 2025 Mar 15;25(1):387. doi: 10.1186/s12909-025-06936-y.
Advancements in understanding spinal disorders and diagnostic techniques have increased the range and complexity of spinal surgeries. However, constraints have arisen in gaining experience techniques through actual surgical cases due to considerations of medical safety, efficiency in working hours, and cost-effectiveness. As such, off-the-job training is expected to play an increasingly significant role. Three-dimensional models have been used for organizing knowledge and training surgical techniques. Their strengths lie in safety, accessibility, and cost-effectiveness. However, their proximity and limited realism make them less suitable for advanced training, restricting their use mainly to beginners. This study evaluates the potential of more realistic models for comprehensive surgical training and explores further applications of them.
MRT, a detailed three-dimensional model developed from real patient computed tomography (CT) data, offers realistic external characteristics and compatibility with radiological imaging. Three types of spine implant surgery seminars were conducted using MRT: (A) cervical pedicle screw placement with fluoroscopy and navigation, (B) a comprehensive mock patient case-from understanding pathology to surgical planning and execution, and (C) lectures and hands-on deformity correction practice for various spinal conditions. Participants evaluated the models and seminars through questionnaires.
Seminar A, comparing MRT to a conventional model (Sawbones), found MRT significantly more realistic in visual and performance realism, as well as tactile feedback (visual realism: MRT 45, Sawbone 26, p = 0.0009; performance realism: MRT 42, Sawbone 17, p = 0.0001; tactile feedback: MRT 40, Sawbone 18, p = 0.009). In Seminar B, MRT provided an immersive experience even for spine surgery specialists, closely mimicking clinical practice (Questions 14-18 regarding psychological aspect, scoring 18-19 out of 20). Open-ended responses noted MRT's unique benefits, such as allowing multiple participants to perform the same procedure for comparative planning and outcomes. Observing vertebral movements during corrective maneuvers further confirmed its educational value.
Enhanced structural detail and realistic simulation make these three-dimensional spinal models highly effective for both novice and specialist training, significantly improving the training experience across skill levels.
对脊柱疾病和诊断技术认识的进步增加了脊柱手术的范围和复杂性。然而，出于医疗安全、工作时间效率和成本效益的考虑，通过实际手术病例积累经验技术受到了限制。因此，非在职培训有望发挥越来越重要的作用。三维模型已被用于组织知识和培训手术技术。它们的优势在于安全性、可及性和成本效益。然而，它们的逼真度和有限的真实感使其不太适合高级培训，主要局限于初学者使用。本研究评估了更逼真模型用于全面手术培训的潜力，并探索其进一步的应用。
MRT是一种根据真实患者计算机断层扫描（CT）数据开发的详细三维模型，具有逼真的外部特征且与放射成像兼容。使用MRT举办了三种类型的脊柱植入手术研讨会：（A）在荧光透视和导航下进行颈椎椎弓根螺钉置入；（B）一个全面的模拟患者病例——从理解病理到手术规划和执行；（C）针对各种脊柱疾病的讲座和手动畸形矫正实践。参与者通过问卷对模型和研讨会进行评估。
在研讨会A中，将MRT与传统模型（Sawbones）进行比较，发现MRT在视觉和操作真实感以及触觉反馈方面明显更逼真（视觉真实感：MRT为45，Sawbone为26，p = 0.0009；操作真实感：MRT为42，Sawbone为17，p = 0.0001；触觉反馈：MRT为40，Sawbone为18，p = 0.009）。在研讨会B中，即使对于脊柱外科专家，MRT也提供了身临其境的体验，非常接近临床实践（关于心理方面的问题14 - 18，得分在20分制中为18 - 19分）。开放式回答指出了MRT的独特优势，例如允许多个参与者进行相同的手术以进行比较规划和结果分析。在矫正操作过程中观察椎体运动进一步证实了其教育价值。
增强的结构细节和逼真的模拟使这些三维脊柱模型对新手和专家培训都非常有效，显著改善了不同技能水平的培训体验。
