REVIEW  3D PRINTING IN ORTHOPEDICS AND TRAUMATOLOGY 

Minerva Orthopedics 2021 August;72(4):365-75

DOI: 10.23736/S2784-8469.21.04056-X

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Simulation in spinal surgery: state of the art and future perspectives of simulation systems for surgical training

Sara CONDINO ¹, Marina CARBONE ¹, Sara BARDERI ², Roberta PIAZZA ³, Vincenzo FERRARI ¹, Paolo PARCHI ² ✉

¹ Department of Information Engineering, EndoCAS Center, University of Pisa, Pisa, Italy; ² First Orthopedic Division, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy; ³ Department of Translational Research and New Technology in Medicine and Surgery, EndoCAS Center, University of Pisa, Pisa, Italy

INTRODUCTION: Mastering surgery and treatments of spine-related conditions require long training times. The need for cost-effective structured training is raising. Training through simulation can potentially revolutionize the standard paradigm if proper simulators are developed and tested. The purpose of this review was to evaluate the literature landscape about the development of spinal simulators.
EVIDENCE ACQUISITION: Eight hundred seventy-nine records were identified through Pubmed database searching, and after removing 8 duplicates, 1 review paper, 2 letters to the editor, 1 editorial, and 1 record not written in English, 866 records were screened through abstract reading.
EVIDENCE SYNTHESIS: The final number of included publications in the systematic review was 26, describing 24 different simulators: 4 purely based on virtual reality, 17 includes synthetic replicas of the anatomy, and 3 deploy ex-vivo samples properly arranged for the simulation.
CONCLUSIONS: This review shows that existing spinal simulators are primarily intended for training in vertebral surgery and that most of the literature considers the presence of physical components to be essential in a spinal simulator. The review shows as well that the type of medical/surgical procedure for which the simulator is intended dictates the number, complexity, and realism of the soft tissues included in the simulation. Finally, only a few studies report neither a subjective nor an objective evaluation of the simulator’s validity; even if preliminary results obtained are encouraging, further research is needed to validate the existing spinal simulators for surgical training and to verify whether skills learned in simulation transfer effectively to clinical practice.

KEY WORDS: Surgical procedures, operative; Orthopedics; Spine