Learning retention of thoracic pedicle screw placement using a high-resolution augmented reality simulator with haptic feedback

Cristian J. Luciano, P. Pat Banerjee, Brad Bellotte, G. Michael Oh, Gerald M Lemole, Fady T. Charbel, Ben Roitberg

Research output: Contribution to journalArticle

45 Scopus citations


BACKGROUND: 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. OBJECTIVE: To evaluate the learning retention of thoracic pedicle screw placement on a high-performance augmented reality and haptic technology workstation. METHODS: 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. RESULTS: With a 12.5% failure rate, a 2-proportion z test yielded P = .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 = .04 from a 2-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. CONCLUSION: 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 = .08) toward learning retention resulting in improvement from practice to test sessions. The performance accuracy showed a 15% mean score improvement and more than a 50% reduction in standard deviation from practice to test. It showed evidence (P = .04) of performance accuracy improvement from practice to test session.

Original languageEnglish (US)
Issue numberSUPPL. 1
Publication statusPublished - Sep 2011



  • Haptics
  • Neurosurgical simulation
  • Thoracic pedicle screw
  • Virtual reality

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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