Hybrid Spine Simulator Prototype for X-ray Free Pedicle Screws Fixation Training

Simulation for surgical training is increasingly being considered a valuable addition to traditional teaching methods. 3D-printed physical simulators can be used for preoperative planning and rehearsal in spine surgery to improve surgical workflows and postoperative patient outcomes. This paper proposes an innovative strategy to build a hybrid simulation platform for training of pedicle screws fixation: the proposed method combines 3D-printed patient-specific spine models with augmented reality functionalities and virtual X-ray visualization, thus avoiding any exposure to harmful radiation during the simulation. Software functionalities are implemented by using a low-cost tracking strategy based on fiducial marker detection. Quantitative tests demonstrate the accuracy of the method to track the vertebral model and surgical tools, and to coherently visualize them in either the augmented reality or virtual fluoroscopic modalities. The obtained results encourage further research and clinical validation towards the use of the simulator as an effective tool for training in pedicle screws insertion in lumbar vertebrae