Learning retention of thoracic pedicle screw placement using a high-resolution augmented reality simulator with haptic feedback.
Learning retention of thoracic pedicle screw placement using a high-resolution augmented reality simulator with haptic feedback.
复制标题
DOI：
10.1227/neu.0b013e31821954ed
复制
发表时间：
2011-09
期刊：
影响因子：
4.8
通讯作者：
Roitberg B
中科院分区：
文献类型：
--
作者：
Luciano CJ;Banerjee PP;Bellotte B;Oh GM;Lemole M Jr;Charbel FT;Roitberg B
我们评估了使用具有3D和触觉反馈的部分任务模拟器作为常见神经外科手术-胸椎椎弓根螺钉放置的培训工具。评价在高性能增强现实和触觉技术工作站上胸椎椎弓根螺钉置入的学习保持。51名研究员和住院医师在模拟器上进行胸椎椎弓根螺钉置入。将虚拟螺钉钻入从真实的患者的计算机断层扫描数据集导出的虚拟患者的胸椎中。失败率为12.5%，双比例z检验得出P= 0.08。对于性能准确度，根据双样本t检验，与椎弓根上入口标志的总欧几里得距离偏差和与椎体中目标标志的相似偏差产生P=0.04，其中被拒绝的零假设假设从实践到测试会话的性能准确度没有改善，备择假设假设有所改善。模拟器上的性能准确度与最近对此类放置进行回顾性评价的文献中报告的准确度相当。失败率表明从实践到测试会话的轻微下降，也表明了从实践到测试会话的改进导致学习保留的趋势（P=0.08）。从实践到测试，性能准确性显示出15%的平均分数提高和超过50%的标准差降低。它显示了证据（P=0.04）的性能准确性提高，从实践到测试会话。
We evaluated the use of a part-task simulator with 3D and haptic feedback as a training tool for a common neurosurgical procedure – placement of thoracic pedicle screws. To evaluate the learning retention of thoracic pedicle screw placement on a high-performance augmented reality and haptic technology workstation. Fifty-one fellows and residents performed thoracic pedicle screw placement on the simulator. The virtual screws were drilled into a virtual patient’s thoracic spine derived from a computed tomography data set of a real patient. With a 12.5% failure rate, a two-proportion z-test yielded P= 0.08. For performance accuracy, an aggregate Euclidean distance deviation from entry landmark on the pedicle and a similar deviation from the target landmark in the vertebral body yielded P=0.04 from a two-sample t-test in which the rejected null hypothesis assumes no improvement in performance accuracy from the practice to the test sessions, and the alternative hypothesis assumes an improvement. The performance accuracy on the simulator was comparable to the accuracy reported in literature on recent retrospective evaluation of such placements. The failure rates indicated a minor drop from practice to test sessions, and also indicated a trend (P=0.08) towards learning retention resulting in improvement from practice to test sessions. The performance accuracy showed a 15% mean score improvement and over 50% reduction in standard deviation from practice to test. It showed evidence (P=0.04) of performance accuracy improvement from practice to test session.