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Randomized Controlled Trial
. 2024 Nov 21;35(1):12.
doi: 10.1007/s00590-024-04123-1.

Virtual reality for surgical training in balloon kyphoplasty procedure

P Capitani  1 , R Joil  2 , C Colonna  2 , G R Schirò  3 , S Legrenzi  3 , L Prandoni  3   2 , A N Bergamini  2 , G Mazzone  2 , S Marino  4 , S Salvadori  2 , L La Verde  2 , S Cascini  2 , M Messori  3   2 , D Capitani  3 , F Bove  3 , P D Giorgi  3
Affiliations
Randomized Controlled Trial

Virtual reality for surgical training in balloon kyphoplasty procedure

P Capitani et al. Eur J Orthop Surg Traumatol. .

Abstract

Purpose: The aim of our prospective randomised trial was to demonstrate the efficacy and improvement in surgical skills of inexperienced surgeons in the balloon kyphoplasty procedures trained with virtual reality (VR) compared to untrained inexperienced surgeons.

Methods: Six orthopaedic residents were randomized to group VR1 (trained) and group VR0 (untrained, control group). At the beginning, all participants, after a theoretical lesson, performed a virtual kyphoplasty. Each resident of the Group VR1 did four training sessions in 1 month (2 h per week) and at the end of training was re-evaluated performing a virtual kyphoplasty. Residents were evaluated with global task completion time and rates subtask ability according to Global Rating Scale of Operative Performance adaptation (both in VR simulation and during the surgery). A percutaneous vertebral augmentation with balloon kyphoplasty was performed by all residents. Intraoperative parameters, complications and cumulative transfer effectiveness ratio (CTER) were analysed.

Results: Intraoperative scores revealed an improvement in the group VR1 between the first VR trial and the intraoperative phase (2.85 ± 0.65 vs. 4.09 ± 0.62, P < 0.05), which was not seen in the group VR0 (2.71 ± 0.71 vs. 2.85 ± 0.75). Statistical analyses indicated significant differences in intraoperative scores between the two groups. The CTER was 0.85 and suggests that 10 training sessions could reduce the procedure time by approximately 8 min in a 15 min of surgery.

Conclusion: Our study about the balloon kyphoplasy reaffirms the potential of VR as an effective and cost-efficient training tool, bridging the gap between theoretical knowledge and practical execution.

Keywords: Balloon kyphoplasty surgical training; Residents; Spine simulators; Transfer; Virtual reality.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Ethical approval: This study was performed according to the standards EN ISO 14155:1, EN ISO 14155:2, Declaration of Helsinki and Good Clinical Practices (GCP). Informed consent: All study participants or their legal guardian provided informed written consent prior to study enrolment.

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