Transpedicular Approach on a Novel Spine Simulator: A Validation Study

David Fürst, Marianne Hollensteiner, Stefan Gabauer, Benjamin Esterer, Klemens Trieb, Felix Eckstein, Andreas Schrempf

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Objective: The popularity of simulation in the medical field has increased dramatically over the last decades. However, the majority of studies focused on laparoscopic or other endoscopic procedures. In this study, participants performed an image-guided surgery task on a novel spine simulator. Face, content, construct, and concurrent validity were examined. Design: A surgical access through both pedicles (transpedicular) into the vertebral body of artificial L3 vertebrae was performed. Questionnaires, a simulation-based performance score, and a specialist rating were used to evaluate the various forms of validity. Setting: Klinikum Wels-Grieskirchen, Wels, Austria; tertiary hospital Participants: According to their expertise in image-guided surgery and pedicle tool insertions, 43 participants were subdivided into 3 groups: 22 novices, 12 intermediates, and 9 experts. Results: Of the novice group, the vast majorities were impressed with the attractiveness and the general appearance of the simulator. The majority of intermediates (92%) and experts (89%) would recommend the simulator to others. According to a simulation-based performance score, experts performed significantly better than novices (p = 0.001, d = 1.52) and intermediates (p = 0.01, d = 1.26). The association between the simulation-based performance score and the specialist rating was strong (R = 0.86, p < 0.01). Conclusions: The novel spine simulator provides an applicable tool for the training of image-guided surgery skills in a realistic design. Its simulation-based assessment score classifies different levels of expertise accurately.

Original languageEnglish
Pages (from-to)1127-1134
Number of pages8
JournalJournal of Surgical Education
Issue number4
Publication statusPublished - 6 Feb 2018


  • Medical Knowledge
  • Patient Care
  • Practice-Based Learning and Improvement
  • specialist rating
  • surgical simulation
  • transpedicular approach
  • validity
  • Education, Medical, Continuing
  • Lumbar Vertebrae/surgery
  • Humans
  • Surgical Instruments
  • Surgery, Computer-Assisted/instrumentation
  • Equipment Design
  • Education, Medical, Graduate
  • Austria
  • Simulation Training/methods
  • Surveys and Questionnaires


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