Surgical (Pedicle Screw Insertion) Simulator

Adolescent Idiopathic Scoliosis (AIS) is a spine deformity commonly found in children age 10 - 17, affecting 0.47% to 5.2% of the global population. A severe form of AIS where it affects the vital organs is seen in 8% of the patients requiring spinal fusion as treatment, to stop the curve progression. The spine fusion includes the insertion of pedicle screws (pedicle screw placement or PSP) into the affected vertebrae, that are further connected with rods PSP is a challenging surgery with a steep learning curve. The major complication includes neurological injury caused by the misplacement of pedicle screws. Currently, training happens on costly cadavers, synthetic bones, or on patients. The objective of this research is to develop a framework for a pedicle screw insertion simulator. The new framework will provide realistic sensations ideally suited for trainees to build up the correct muscle memory. The framework consists of a virtual bone and a model of drilling dynamics constructed through machine learning. Several parameters (forces, torques, vibration, and acoustics) of the drilling dynamics are obtained from experiments. The framework will be equipped with skill capturing and assessment features by utilizing motion tracking sensors. An expert surgeon's parameters (e.g. kinesthetic) while using the haptic device, in combination with the motion tracking sensor will be captured, and stored as the reference model for the skill assessment system, to be compared with the user's model throughout the simulation. This and other user data (force exerted, haptic position) will be then translated into a performance matrix which will help the user refine his/her technique. The data from the motion capture will also enhance the system and increase its performance. The refined model is then clinically validated by inviting expert surgeons as assessors, and junior surgeons to assess the fidelity and realism of the simulator with support from RAS, SI and STEPS Skill Centre.