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  • Neurosurgical training with a novel MINIMALLY INVASIVE SPINE SIMULATOR: percutaneous lumbar pedicle screw placement

    Final Number:

    Rohan Chitale MD; Peter Campbell MD; George M. Ghobrial MD; James S. Harrop MD, FACS

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Development of operative skills is paramount for neurosurgical trainees. Demand for surgical education outside the operating room has sparked advancements in simulator-based learning models. Our goal is to establish an educational curriculum for teaching minimally invasive techniques of pedicle screw placement using a computer-enhanced physical model of percutaneous pedicle screw placement.

    Methods: A two hour educational curriculum was created to teach neurosurgical residents both anatomy and technique associated with image-guided pedicle screw placement. Based on a pre-determined grading rubric, scores were given to each participating trainee reflecting his success in determining pedicle screw starting point and trajectory with both fluoroscopy and CT navigation. In addition, trainees were evaluated through a written exam. Pre-didactic and post-didactic practical and written scores were analyzed and compared.

    Results: Eight trainees participated in this module. Average score on written test improved from 78% to 100%. Technical score for fluoroscopic guidance improved from first attempt (58.8) to second attempt (52.9), with lower scores reflecting better results. Technical score for CT navigated guidance also improved from 28.3 to 26.6. There was statistically significant improvement in both the written didactic score (P=0.0000189) and the technical score (P=0.0000756).

    Conclusions: Both didactic sessions and hands-on training with surgical simulators improved objectively measured resident performance. A minimally invasive spine simulation model and curriculum may serve a valuable function in the education of neurosurgical residents.

    Patient Care: Better training with the use of simulators through a formal educational curriculum should improve resident technical skills and translate into improved patient outcomes.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of didactic and technical components in neurosurgical education, 2) Discuss, in small groups, the further advancement of education in neurosurgery, 3) Understand the process to design and implement an educational algorithm.


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