Fisher Kalin J, Satin Alexander M, Ohnmeiss Donna D, Guyer Richard D
Texas Back Institute, Plano, TX.
Texas Back Institute Research Foundation, Plano, TX.
Spine (Phila Pa 1976). 2025 Aug 15;50(16):E314-E323. doi: 10.1097/BRS.0000000000005386. Epub 2025 May 7.
Narrative review of the literature related to physical and virtual simulation in spine surgery training.
The purpose of this narrative review was to provide an overview of the development of simulated spine surgery, its current role, and future potential use in the training of surgical skills.
Residents and fellows are expected to become proficient in an ever-increasing number of spine surgery techniques. While the standard training for surgery has traditionally involved the use of cadaveric specimens, there are inherent challenges with the specimens including cost, storage, shipping, and anatomic abnormalities or inconsistent quality. Various synthetic and virtual spine models have been produced upon which surgical skills can be practiced.
For this narrative review, a comprehensive literature search was performed to identify relevant articles reporting on the use of physical and/or virtual surgery simulators in the training of spine surgeons.
To date, a variety of study formats and simulated models have been described. Study participants most commonly include neurosurgical and/or orthopaedic surgery residents. Despite the heterogeneity of the studies, almost all have found benefit from the simulated training on a range of variables including pedicle screw placement, procedure time, and trainee confidence.
Modern advancements in material engineering and computer science have led to high-fidelity virtual and physical spine surgery simulation models. These models provide a safe environment for practice while addressing some of the limitations inherent to the modern surgical training model. While the literature consistently demonstrates a benefit of simulation compared with traditional teaching, more information is needed to determine if simulation training translates to improved real-world surgical outcomes. Future work should focus on establishing objective benchmarks for competency and expert status.
对脊柱外科手术培训中物理模拟和虚拟模拟相关文献的叙述性综述。
本叙述性综述的目的是概述模拟脊柱手术的发展、其当前作用以及在手术技能培训中的未来潜在用途。
住院医师和专科住院医生需要熟练掌握越来越多的脊柱外科手术技术。虽然传统的外科手术标准培训涉及使用尸体标本，但这些标本存在一些固有挑战，包括成本、储存、运输以及解剖异常或质量不一致等问题。已经制作了各种合成和虚拟脊柱模型，可用于练习手术技能。
对于本叙述性综述，进行了全面的文献检索，以确定报告在脊柱外科医生培训中使用物理和/或虚拟手术模拟器的相关文章。
迄今为止，已经描述了多种研究形式和模拟模型。研究参与者最常见的是神经外科和/或骨科住院医师。尽管研究存在异质性，但几乎所有研究都发现模拟培训在包括椎弓根螺钉置入、手术时间和学员信心等一系列变量方面都有好处。
材料工程和计算机科学的现代进展催生了高保真虚拟和物理脊柱手术模拟模型。这些模型提供了一个安全的练习环境，同时解决了现代手术培训模式固有的一些局限性。虽然文献一致表明模拟培训相比传统教学有好处，但还需要更多信息来确定模拟培训是否能转化为改善实际手术效果。未来的工作应侧重于为能力和专家地位建立客观的基准。
