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Erschienen in: Archives of Orthopaedic and Trauma Surgery 6/2018

01.03.2018 | Orthopaedic Surgery

Virtual surgery simulation versus traditional approaches in training of residents in cervical pedicle screw placement

verfasst von: Yang Hou, Jiangang Shi, Yanping Lin, Huajiang Chen, Wen Yuan

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 6/2018

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Abstract

Introduction

The cervical screw placement is one of the most difficult procedures in spine surgery, which often needs a long period of repeated practices and could cause screw placement-related complications. We performed this cadaver study to investigate the effectiveness of virtual surgical training system (VSTS) on cervical pedicle screw instrumentation for residents.

Materials and methods

A total of ten novice residents were randomly assigned to two groups: the simulation training (ST) group (n = 5) and control group (n = 5). The ST group received a surgical training of cervical pedicle screw placement on VSTS and the control group was given an introductory teaching session before cadaver test. Ten fresh adult spine specimens including 6 males and 4 females were collected, and were randomly allocated to the two groups. The bilateral C3–C6 pedicle screw instrumentation was performed in the specimens of the two groups, respectively. After instrumentation, screw positions of the two groups were evaluated by image examinations.

Results

There was significantly statistical difference in screw penetration rates between the ST (10%) and control group (62.5%, P < 0.05). The acceptable rates of screws were 100 and 50% in the ST and control groups with significant difference between each other (P < 0.05). In addition, the average screw penetration distance in the ST group (1.12 ± 0.47 mm) was significantly lower than the control group (2.08 ± 0.39 mm, P < 0.05).

Conclusions

This study demonstrated that the VSTS as an advanced training tool exhibited promising effects on improving performance of novice residents in cervical pedicle screw placement compared with the traditional teaching methods.
Literatur
1.
Zurück zum Zitat Kim YJ, Lenke LG, Kim J et al (2006) Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine 31:291–298CrossRefPubMed Kim YJ, Lenke LG, Kim J et al (2006) Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine 31:291–298CrossRefPubMed
2.
Zurück zum Zitat Ebraheim NA, Xu R, Ahmad M et al (1977) Projection of the thoracic pedicle and its morphometric analysis. Spine 22:233–238CrossRef Ebraheim NA, Xu R, Ahmad M et al (1977) Projection of the thoracic pedicle and its morphometric analysis. Spine 22:233–238CrossRef
3.
Zurück zum Zitat Lonstein JE, Denis F, Perra JH et al (1999) Complications associated with pedicle screws. J Bone Joint Surg Am 81:1519–1528CrossRefPubMed Lonstein JE, Denis F, Perra JH et al (1999) Complications associated with pedicle screws. J Bone Joint Surg Am 81:1519–1528CrossRefPubMed
4.
Zurück zum Zitat Gelalis ID, Paschos NK, Pakos EE et al (2012) Accuracy of pedicle screw placement: a systematic review of prospective in vivo studies comparing free hand, uroscopy guidance and navigation techniques. Eur Spine J 21:247–255CrossRefPubMed Gelalis ID, Paschos NK, Pakos EE et al (2012) Accuracy of pedicle screw placement: a systematic review of prospective in vivo studies comparing free hand, uroscopy guidance and navigation techniques. Eur Spine J 21:247–255CrossRefPubMed
5.
Zurück zum Zitat Gautschi OP, Schatlo B, Schaller K et al (2011) Clinically relevant complications related to pedicle screw placement in thoracolumbar surgery and their management: a literature review of 35,630 pedicle screws. Neurosurg Focus 31:E8CrossRefPubMed Gautschi OP, Schatlo B, Schaller K et al (2011) Clinically relevant complications related to pedicle screw placement in thoracolumbar surgery and their management: a literature review of 35,630 pedicle screws. Neurosurg Focus 31:E8CrossRefPubMed
6.
Zurück zum Zitat Lee GY, Massicotte EM, Rampersaud YR (2007) Clinical accuracy of cervicothoracic pedicle screw placement: a comparison of the “open” lamino-foraminotomy and computer-assisted techniques. J Spinal Disord Tech 20:25–32CrossRefPubMed Lee GY, Massicotte EM, Rampersaud YR (2007) Clinical accuracy of cervicothoracic pedicle screw placement: a comparison of the “open” lamino-foraminotomy and computer-assisted techniques. J Spinal Disord Tech 20:25–32CrossRefPubMed
7.
Zurück zum Zitat Ludwig SC, Kramer DL, Balderston RA et al (2000) Placement of pedicle screws in the human cadaveric cervical spine: comparison accuracy of three techniques. Spine 25:1655–1667CrossRefPubMed Ludwig SC, Kramer DL, Balderston RA et al (2000) Placement of pedicle screws in the human cadaveric cervical spine: comparison accuracy of three techniques. Spine 25:1655–1667CrossRefPubMed
8.
Zurück zum Zitat Sakai Y, Matsuyama Y, Nakamura H et al (2008) Segmental pedicle screwing for idiopathic scolliosis using computed-assisted surgery. J Spinal Disord Tech 21:181–186CrossRefPubMed Sakai Y, Matsuyama Y, Nakamura H et al (2008) Segmental pedicle screwing for idiopathic scolliosis using computed-assisted surgery. J Spinal Disord Tech 21:181–186CrossRefPubMed
9.
Zurück zum Zitat Mohamed M, Eldin M (2014) Cervical pedicle screw fixation: anatomic feasibility of pedicle morphology and radiologic evaluation of the anatomical measurements. Asian Spine J 8:273–280CrossRef Mohamed M, Eldin M (2014) Cervical pedicle screw fixation: anatomic feasibility of pedicle morphology and radiologic evaluation of the anatomical measurements. Asian Spine J 8:273–280CrossRef
10.
Zurück zum Zitat Cong Y, Bao N, Zhao J (2015) Comparing accuracy of cervical pedicle screw placement between a guidance system and manual manipulation: a cadaver study. Med Sci Monit 21:2672–2677CrossRefPubMedPubMedCentral Cong Y, Bao N, Zhao J (2015) Comparing accuracy of cervical pedicle screw placement between a guidance system and manual manipulation: a cadaver study. Med Sci Monit 21:2672–2677CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Shimokawa N, Takami T (2017) Surgical safety of cervical pedicle screw placement with computer navigation system. Neurosurg Rev 40:251–258CrossRefPubMed Shimokawa N, Takami T (2017) Surgical safety of cervical pedicle screw placement with computer navigation system. Neurosurg Rev 40:251–258CrossRefPubMed
12.
Zurück zum Zitat Lee DH, Lee SW, Kang SJ et al (2011) Optimal entry points and trajectories for cervical pedicle screw placement into subaxial cervical vertebrae. Eur Spine J 20:905–911 Lee DH, Lee SW, Kang SJ et al (2011) Optimal entry points and trajectories for cervical pedicle screw placement into subaxial cervical vertebrae. Eur Spine J 20:905–911
13.
Zurück zum Zitat Uehara M, Takahashi J, Ogihara N et al (2012) Cervical pedicle screw fixation combined with laminoplasty for cervical spondylotic myelopathy with instability. Asian Spine J 6:241–248CrossRefPubMedPubMedCentral Uehara M, Takahashi J, Ogihara N et al (2012) Cervical pedicle screw fixation combined with laminoplasty for cervical spondylotic myelopathy with instability. Asian Spine J 6:241–248CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Abumi K (2015) Cervical spondylotic myelopathy: posterior decompression and pedicle screw fixation. Eur Spine J 24(Suppl 2):186–196CrossRefPubMed Abumi K (2015) Cervical spondylotic myelopathy: posterior decompression and pedicle screw fixation. Eur Spine J 24(Suppl 2):186–196CrossRefPubMed
15.
Zurück zum Zitat Karhade AV, Vasudeva VS, Pompeu YA et al (2016) Image guided spine surgery: available technology and future potential. Austin Neurosurg Open Access 3:1043 Karhade AV, Vasudeva VS, Pompeu YA et al (2016) Image guided spine surgery: available technology and future potential. Austin Neurosurg Open Access 3:1043
16.
Zurück zum Zitat Badash I, Burtt K, Solorzano CA et al (2016) Innovations in surgery simulation: a review of past, current and future techniques. Ann Transl Med 4:453CrossRefPubMedPubMedCentral Badash I, Burtt K, Solorzano CA et al (2016) Innovations in surgery simulation: a review of past, current and future techniques. Ann Transl Med 4:453CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Harrop J, Rezai AR, Hoh DJ et al (2013) Neurosurgical training with a novel cervical spine simulator: posterior foraminotomy and laminectomy. Neurosurgery 73(Suppl 1):94–99CrossRefPubMed Harrop J, Rezai AR, Hoh DJ et al (2013) Neurosurgical training with a novel cervical spine simulator: posterior foraminotomy and laminectomy. Neurosurgery 73(Suppl 1):94–99CrossRefPubMed
18.
Zurück zum Zitat Gottschalk MB, Yoon ST, Park DK et al (2015) Surgical training using three-dimensional simulation in placement of cervical lateral mass screws: a blinded randomized control trial. Spine J 15:168–175CrossRefPubMed Gottschalk MB, Yoon ST, Park DK et al (2015) Surgical training using three-dimensional simulation in placement of cervical lateral mass screws: a blinded randomized control trial. Spine J 15:168–175CrossRefPubMed
Metadaten
Titel
Virtual surgery simulation versus traditional approaches in training of residents in cervical pedicle screw placement
verfasst von
Yang Hou
Jiangang Shi
Yanping Lin
Huajiang Chen
Wen Yuan
Publikationsdatum
01.03.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 6/2018
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-018-2906-0

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