A novel simulation model for minimally invasive spine surgery.

摘要: OBJECTIVE Minimally invasive spine surgery (MISS) is among the fastest growing technologies in general neurosurgical practice. In addition, great demand exists to teach these skills neurosurgery residents. With newly enforced work hour restrictions, opportunities acquire are limited, necessitating development of alternative strategies education. We describe a novel simulation model for MISS supplemented by resident self-assessment analysis and evaluation. METHODS The simulator was constructed using nontransparent Plexiglas frame with modified halo on which affix specimens. Interchangeable copper tubing affixed 360-degree pivot system replicate working portal. Deer skulls spines were then collected prepared accordingly. Laboratory exercises based resident's level training emphasis proper drilling techniques. Eight residents asked complete survey regarding their competence scale 0 5, both before after completing skill sets. Additionally, they an exit that used assess exercises. RESULTS All completed successfully exception placing 2 separate pedicle screws through same portal, posed difficulty some specimens because lack lordosis specimens, leading unfavorable trajectories free-hand technique. regard analysis, mean confidence rating performing laminectomy improved difference 1.25 points (n = 8; 95% interval, 0.66-1.84; P 0.0015), from 2.50 3.75 exercises, respectively, reached statistical significance. For senior-level residents, placement technique 1.00 3; -1.48-3.48; 0.225), 3.33 4.33 respectively. Results encouraging. CONCLUSION feasible, inexpensive, reproducible adjunct provides new teaching method surgery. Further investigation this technology warranted, although multicenter, randomized, controlled trials assessing its validity may not be practical ethical constraints patient safety.