Simulated lumbar minimally invasive surgery educational model with didactic and technical components.
BACKGROUND
The learning and development of technical skills are paramount for neurosurgical trainees. External influences and a need for maximizing efficiency and proficiency have encouraged advancements in simulator-based learning models.


OBJECTIVE
To confirm the importance of establishing an educational curriculum for teaching minimally invasive techniques of pedicle screw placement using a computer-enhanced physical model of percutaneous pedicle screw placement with simultaneous didactic and technical components.


METHODS
A 2-hour educational curriculum was created to educate neurosurgical residents on anatomy, pathophysiology, and technical aspects associated with image-guided pedicle screw placement. Predidactic and postdidactic practical and written scores were analyzed and compared. Scores were calculated for each participant on the basis of the optimal pedicle screw starting point and trajectory for both fluoroscopy and computed tomographic navigation.


RESULTS
Eight trainees participated in this module. Average mean scores on the written didactic test improved from 78% to 100%. The technical component scores for fluoroscopic guidance improved from 58.8 to 52.9. Technical score for computed tomography-navigated guidance also improved from 28.3 to 26.6.


CONCLUSIONS
Didactic and technical quantitative scores with a simulator-based educational curriculum improved objectively measured resident performance. A minimally invasive spine simulation model and curriculum may serve a valuable function in the education of neurosurgical residents and outcomes for patients.
*Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; ‡Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
Rohan
R
Chitale
George M
GM
Ghobrial
Darlene
D
Lobel
James
J
Harrop
D000328:Adult; D001863:Bone Screws; D002983:Clinical Competence; D003479:Curriculum; D005471:Fluoroscopy; D006801:Humans; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000193:education* / Q000379:methods*; D008953:Models, Anatomic; D038361:Neuronavigation; D009493:Neurosurgery / Q000193:education*; D019635:Neurosurgical Procedures / Q000193:education* / Q000379:methods*; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed