Yuan Lei, Zhang Zhiqi, Zhou Feifei, Xia Tian, Xu Nanfang, Sun Zhuoran
Department of Orthopedics, Peking University Third Hospital, No 49. North Garden Street, Hai Dian District, Beijing, 100191, China.
Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China.
BMC Med Educ. 2025 Jul 26;25(1):1119. doi: 10.1186/s12909-025-07695-6.
To evaluate the efficacy of Virtual Reality Force Feedback Spine Surgery Training Simulators (VRFF-SSTS) in enhancing the skills of spinal pedicle screw placement (PSP) among orthopedic fellows in continuing medical education, and whether influenced by seniority and spinal location.
A multi-centered, cross-sectional study enrolled fellows from three tertiary care referral hospitals. Participants were categorized into three groups (A, B, and C) based on their post-graduation year (PGY), reflecting their hierarchical order of spine-surgical training: A (PGY1-5), B (PGY6-10), and C (> 10). Participants performed SPSP in the spinal saw bone model using the free-hand technique first, followed by training on IVRSS. The outcome before and after training was assessed on placement accuracy and overall competency through an objective rating scale.
Sixty-four participants were included, with PGY A, B, and C 18 (28.1%),30 (46.9%), and 16 (25.0%) participants, respectively. Pre-training data indicated that screw placement accuracy improved with increasing seniority. The accuracy of lumbar pedicle screw placement surpassed that of atlantoaxial, subaxial cervical, and thoracic vertebrae. Post-training, there was a significant enhancement in screw placement accuracy across all groups compared to pre-training (p < 0.001), with no significant differences observed between seniority levels and spinal regions. Overall competency significantly improved following training, with PGY B and C fellows, who had prior experience with pedicle screw insertion, demonstrating more satisfactory performance.
VRFF-SSTS proves to be an invaluable tool for training surgical skills, capable of enhancing the accuracy of pedicle screw placement for junior spine surgeons within a constrained training period. However, the overall competency in pedicle screw placement remains superior among experienced surgeons compared to their junior counterparts, underscoring the ongoing importance of clinical practice.
Not applicable.
评估虚拟现实力反馈脊柱手术训练模拟器（VRFF-SSTS）在继续医学教育中提高骨科住院医师脊柱椎弓根螺钉置入（PSP）技能方面的效果，以及是否受资历和脊柱部位的影响。
一项多中心横断面研究招募了来自三家三级医疗转诊医院的住院医师。参与者根据毕业后年份（PGY）分为三组（A、B和C），反映他们脊柱手术训练的层级顺序：A组（PGY1-5）、B组（PGY6-10）和C组（>10）。参与者首先在脊柱锯骨模型中使用徒手技术进行SPSP，然后在IVRSS上进行训练。通过客观评分量表在训练前后评估置入准确性和整体能力方面的结果。
纳入64名参与者，PGY A组、B组和C组分别有18名（28.1%）、30名（46.9%）和16名（25.0%）参与者。训练前数据表明，随着资历增加，螺钉置入准确性提高。腰椎椎弓根螺钉置入的准确性超过寰枢椎、颈椎下颈椎和胸椎。训练后，与训练前相比，所有组的螺钉置入准确性均有显著提高（p<0.001），资历水平和脊柱区域之间未观察到显著差异。训练后整体能力显著提高，有椎弓根螺钉置入经验的PGY B组和C组住院医师表现更令人满意。
VRFF-SSTS被证明是一种训练手术技能的宝贵工具，能够在有限的训练期内提高初级脊柱外科医生椎弓根螺钉置入的准确性。然而，与初级医生相比，经验丰富的外科医生在椎弓根螺钉置入方面的整体能力仍然更胜一筹，这突出了临床实践持续的重要性。
不适用。
