Virtual Reality–Enabled Resident Education of Lateral-Access Spine Surgery

Abstract

OBJECTIVELateral access spine surgery has many benefits, but adoption has been limited by a steep learning curve. Virtual reality (VR) is gaining popularity and lends itself as a useful tool in enhancing neurosurgical resident education. We thus sought to assess if VR-based simulation could enhance the training of neurosurgery residents in lateral spine surgery. METHODSNeurosurgery residents completed a VR-based lateral spine module on lateral patient positioning and performing lateral lumbar interbody fusion (LLIF) using the PrecisionOS VR system on the Meta Quest 2 headset. Simulation occurred 1x/week every other week for a total of 3 simulations over 6 weeks. Pre- and post-intervention surveys as well as intra-simulation performance metrics were assessed over time. RESULTSThe majority of resident participants showed improvement in performance scores, including an automated PrecisionOS precision score, number of X-rays used within the simulation, and time to completion. All participants showed improvement in comfort with anatomic landmarks for lateral access surgery, confidence performing lateral surgery without direct supervision, and assessing fluoroscopy in spine surgery for hardware placement and image interpretation. Participant perception on the utility of VR as an educational tool also improved. CONCLUSIONVR-based simulation enhanced neurosurgical residents’ ability to understand lateral access surgery. Immersive surgical simulation resulted in improved resident confidence with surgical technique and workflow, perceived improvement in anatomical knowledge, and simulation performance scores. Trainee perceptions on virtual simulation and training as a curriculum supplement also improved following completion of VR training.