Development of a VR Simulator for Training of Posterior Cervical Spine Fusion Surgery

Abstract

AbstractIt is important to avoid iatrogenic injuries of nerves and blood vessels during the pedicle screw insertion stage of posterior cervical spine decompression and fusion surgery. First, it is necessary to determine the length and angulation of the pedicle screws for safety and stability. Second, it is necessary to drill precise preparation holes for the pedicle screws using a pedicle probe. In this work, we developed a VR training system for pedicle screw planning and basic drilling skills. The VR system was built with a pen‐style haptic device and a head‐mounted display. Trainees used the haptic pen as a virtual pedicle probe. In order to simulate bone hardness and stress accumulation at the virtual pedicle probe tip in the virtual surgery, we developed a voxel‐based bone drilling simulator. To reduce the heavy load required for voxel processing, the simulator was constructed as a hybrid system that included a removal volume voxel model for drilling areas and a fixed polygonal mesh model for other areas. 3D models of a cervical spine were generated from CT scan images of a patient. This paper evaluated the system through a subjective evaluation by a specialist and via the training results for novice trainees. We discuss the evaluation results and training effectiveness with the simulator. © 2020 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC.