VRSpineSim: Applying Educational Aids Within A Virtual Reality Spine Surgery Simulator

  • Ahmed E. MostafaEmail author
  • Won Hyung Ryu
  • Sonny Chan
  • Kazuki Takashima
  • Gail Kopp
  • Mario Costa Sousa
  • Ehud Sharlin
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 11542)


We contribute VRSpineSim, a stereoscopic virtual reality surgery simulator that allows novice surgeons to learn and experiment with a spinal pedicle screw insertion (PSI) procedure using simplified interaction capabilities and 3D haptic user interfaces. By collaborating with medical experts and following an iterative approach, we provide characterization of the PSI task, and derive requirements for the design of a 3D immersive interactive simulation system. We present how these requirements were realized in our prototype and outline its educational benefits for training the PSI procedure. We conclude with the results of a preliminary evaluation of VRSpineSim and reflect on our interface benefits and limitations for future relevant research efforts.


Immersive simulation Spine surgery Education 


  1. 1.
    Brooke, J., et al.: SUS - a quick and dirty usability scale. Usability Eval. Indus. 189(194), 4–7 (1996)Google Scholar
  2. 2.
    Brunozzi, D., Shakur, S.F., Kwasnicki, A., Ismail, R., Charbel, F.T., Alaraj, A.: Role of immersive touch simulation in neurosurgical training. In: Alaraj, A. (ed.) Comprehensive Healthcare Simulation: Neurosurgery. CHS, pp. 185–198. Springer, Cham (2018). Scholar
  3. 3.
    Clark, A.D., Barone, D.G., Candy, N., Guilfoyle, M., et al.: The effect of 3-dimensional simulation on neurosurgical skill acquisition and surgical performance: a review of the literature. Surg. Educ. 74, 828–836 (2017)CrossRefGoogle Scholar
  4. 4.
    Coles, T.R., Meglan, D., et al.: The role of haptics in medical training simulators: a survey of the state of the art. IEEE Trans. Haptics 4(1), 51–66 (2011)CrossRefGoogle Scholar
  5. 5.
    Greenberg, S., Buxton, B.: Usability evaluation considered harmful (some of the time). In: Proceedings of SIGCHI, CHI 2008, pp. 111–120. ACM (2008)Google Scholar
  6. 6.
    Henriksen, K., Patterson, M.D.: Simulation in health care: setting realistic expectations. Patient Saf. 3(3), 127–134 (2007)Google Scholar
  7. 7.
    ImmersiveTouch: A leader in simulation based surgical training. (2017)
  8. 8.
    Klein, S., Whyne, C.M., et al.: CT-based patient-specific simulation software for pedicle screw insertion. Clin. Spine Surg. 22(7), 502–506 (2009)Google Scholar
  9. 9.
    Mostafa, A.E., Ryu, W.H.A., Takashima, K., et al.: ReflectiveSpineVR: an immersive spine surgery simulation with interaction history capabilities. In: the 5th Symposium on Spatial User Interaction, SUI 2017, pp. 20–29. ACM (2017)Google Scholar
  10. 10.
    Mostafa, A.E., Ryu, W.H.A., et al.: Designing NeuroSimVR: a stereoscopic virtual reality spine surgery simulator. Technical report, University of Calgary (2017)Google Scholar
  11. 11.
    Naddeo, F., Cataldo, E., Naddeo, A., Cappetti, N., Narciso, N.: An automatic and patient-specific algorithm to design the optimal insertion direction of pedicle screws for spine surgery templates. Med. Biol. Eng. Comput. 55, 1549–1562 (2017)CrossRefGoogle Scholar
  12. 12.
    Nielsen, J.: Usability metrics: tracking interface improvements. IEEE Softw. 13(6), 12 (1996)Google Scholar
  13. 13.
    Pelargos, P.E., Nagasawa, D.T., Lagman, C., Tenn, S., et al.: Utilizing virtual and augmented reality for educational and clinical enhancements in neurosurgery. Clin. Neurosci. 35, 1–4 (2017)CrossRefGoogle Scholar
  14. 14.
    Pfandler, M., Lazarovici, M., Stefan, P., Wucherer, P., Weigl, M.: Virtual reality based simulators for spine surgery: a systematic review. Spine J. 17, 1352–1363 (2017)CrossRefGoogle Scholar
  15. 15.
    Ryu, W.H.A., Mostafa, A.E., Dharampal, N., et al.: Design-based comparison of spine surgery simulators: optimizing educational features of surgical simulators. World Neurosurg. 106, 870–877 (2017)CrossRefGoogle Scholar
  16. 16.
    Schuler, D., Namioka, A.: Participatory Design: Principles and Practices. CRC Press, Boca Raton (1993)Google Scholar
  17. 17.
    Seymour, N.E., Gallagher, A.G., Roman, S.A., et al.: Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann. Surg. 236(4), 458 (2002)CrossRefGoogle Scholar
  18. 18.
    Stanney, K.M., Mollaghasemi, M., et al.: Usability engineering of virtual environments (VEs): identifying multiple criteria that drive effective VE system design. Int. J. Hum.-Comput. Stud. 58(4), 447–481 (2003)CrossRefGoogle Scholar
  19. 19.
    Xiang, L., Zhou, Y., Wang, H., et al.: Significance of preoperative planning simulator for junior surgeons’ training of pedicle screw insertion. Spinal Disord. Tech. 28(1), E25–E29 (2015)CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of CalgaryCalgaryCanada
  2. 2.Tohoku UniversitySendaiJapan

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