The Usefulness and Potential of High-fidelity Three-dimensional Models in Spine Surgery Training: Cross-sectional Empirical Study

Background: Advancements in understanding spinal disorders and diagnostic techniques have increased the range and complexity of spinal surgeries. However, constraints have arisen in gaining experience techniques through actual surgical cases due to considerations of medical safety, efficiency in working hours, and cost-effectiveness. As such, off-the-job training is expected to play an increasingly significant role. Three-dimensional models have been used for organizing knowledge and training surgical techniques. Their strengths lie in safety, accessibility, and cost-effectiveness. However, their proximity and limited realism make them less suitable for advanced training, restricting their use mainly to beginners. This study evaluates the potential of more realistic models for comprehensive surgical training and explores further applications of them.

Methods: MRT, a detailed three-dimensional model developed from real patient computed tomography (CT) data, offers realistic external characteristics and compatibility with radiological imaging. Three types of spine implant surgery seminars were conducted using MRT: (A) cervical pedicle screw placement with fluoroscopy and navigation, (B) a comprehensive mock patient case-from understanding pathology to surgical planning and execution, and (C) lectures and hands-on deformity correction practice for various spinal conditions. Participants evaluated the models and seminars through questionnaires.

Results: Seminar A, comparing MRT to a conventional model (Sawbones), found MRT significantly more realistic in visual and performance realism, as well as tactile feedback (visual realism: MRT 45, Sawbone 26, p = 0.0009; performance realism: MRT 42, Sawbone 17, p = 0.0001; tactile feedback: MRT 40, Sawbone 18, p = 0.009). In Seminar B, MRT provided an immersive experience even for spine surgery specialists, closely mimicking clinical practice (Questions 14-18 regarding psychological aspect, scoring 18-19 out of 20). Open-ended responses noted MRT's unique benefits, such as allowing multiple participants to perform the same procedure for comparative planning and outcomes. Observing vertebral movements during corrective maneuvers further confirmed its educational value.

Conclusions: Enhanced structural detail and realistic simulation make these three-dimensional spinal models highly effective for both novice and specialist training, significantly improving the training experience across skill levels.