The usefulness of vertebral needle targeting simulation training system using ray-summation imaging: experimental study.

ABSTRACT

PURPOSE: Using the multi-detector computed tomography and related three-dimensional imaging technology, we developed a vertebral needle targeting simulation training system named spinal needling intervention practice using ray-summation imaging (SNIPURS). Herein, we assessed the utility of SNIPURS by evaluating changes in the learning curves of SNIPURS trainees. METHODS: Twenty-one examinees were enrolled seven experienced operators (expert group), seven trainees with coaching (coaching group), and seven trainees without coaching (non-coaching group). They performed six tests of vertebral needle targeting simulation on the workstation-generated spinal ray-summation images of six patients with vertebral fractures. In each test, they determined the bilateral trans-pedicular puncture points and angles on two thoracic and two lumbar vertebrae on ray-summation imaging (i.e., 8 simulations per test). The coaching group received coaching by a trainer after Tests 1 and 4, while the others did not. Scores were given based on the trans-pedicular pathway (1 point) or not (0 point). Eight virtual needles were evaluated in each of Tests 1-6. RESULTS: Among the three groups, the expert group had the highest average scores on Tests 1-4 (expert 3.86, 6.57, 7.43, and 7.57; coaching 1.86, 6.14, 6, and 6.29; and non-coaching 1.14, 4.14, 4.71, and 4.86). The coaching group's scores caught up with the expert groups' average scores on Tests 5 and 6, whereas those of the non-coaching group did not (expert and coaching 7.86 and 8.00, non-coaching 5.86 and 7.14). All examinees in the expert and coaching groups achieved a perfect score on the final Test 6, whereas three of the seven non-coaching trainees did not. CONCLUSION: SNIPURS might be suitable for vertebral needle targeting training. The coaching provided during SNIPURS training helped the trainees to acquire the spinal puncture techniques in PVP.