Virtual reality based simulators for spine surgery: a systematic review

Publication date: Available online 29 May 2017
Source:The Spine Journal
Author(s): Michael Pfandler, Marc Lazarovici, Philipp Stefan, Patrick Wucherer, Matthias Weigl
Background ContextVirtual reality (VR) based simulators offer numerous benefits and are very useful in assessing and training surgical skills. Although they are standard in some surgical subspecialties, their actual use in spinal surgery remains unclear. Currently, only technical reviews of VR based simulators are available for spinal surgery.PurposeThus, we performed a systematic review which examined the existing research on VR based simulators in spinal procedures. We also assessed the quality of current studies evaluating VR based training in spinal surgery. Moreover, we wanted to provide a guide for future studies evaluating VR based simulators in this field.Study Design and SettingThis is a systematic review of the current scientific literature regarding VR based simulation in spinal surgery.MethodsFive data sources were systematically searched to identify relevant peer-reviewed papers regarding virtual, mixed, or augmented reality based simulators in spinal surgery. A qualitative data synthesis was performed with particular attention to evaluation approaches and outcomes. Additionally, all included studies were appraised for their quality using the MERSQI tool. This research is supported through the German Research Foundation (DFG, Funding number: WE 4682/4-1) and the Munich Centre for Health Sciences (MC-Health).ResultsThe initial review identified 476 abstracts and 63 full-texts were then assessed by two reviewers. Finally, 19 studies were selected which examined simulators for the following procedures: Pedicle Screw Placement, Vertebroplasty, Posterior Cervical Laminectomy and Foraminotomy, Lumbar Puncture, Facet Joint Injection, and Spinal Needle Insertion/Placement. These studies had a low to medium methodological quality with a MERSQI mean score of 11.47 out of 18 (standard deviation = 1.81).ConclusionThis review described the current state and applications of VR based simulator training and assessment approaches in spinal procedures. Limitations, strengths, and future advancements of VR based simulators for training and assessment in spinal surgery were explored. Higher quality studies with patient-related outcome measures are needed. To establish further adaptation of VR based simulators in spinal surgery, future evaluations need to improve study quality, apply long-term study designs, and examine non-technical skills as well as multi-disciplinary team-training.



http://ift.tt/2qvXw2E