http://hdl.handle.net/10027/7194 Sun, 26 May 2013 04:58:47 GMT 2013-05-26T04:58:47Z http://hdl.handle.net/10027/8753 Learning Retention of Thoracic Pedicle Screw Placement Using a High-Resolution Augmented Reality Simulator With Haptic Feedback Luciano, Cristian J; Banerjee, P Pat; Bellotte, Brad; Oh, G Michael; Lemole, Michael; Charbel, Fady T.; Roitberg, Ben Background. In this study we evaluated the use of a part-task simulator with 3D and haptic feedback as a training tool for a common neurosurgical procedure – placement of thoracic pedicle screws. Objective. The purpose of this study was to evaluate the learning retention of thoracic pedicle screw placement on a high-performance augmented reality and haptic technology workstation. Methods. Fifty one fellows and residents performed thoracic pedicle screw placement on the simulator. The virtual screws were drilled into a virtual patient’s thoracic spine derived from a computed tomography data set of a real patient. Results: With a 12.5% failure rate, a two-proportion z-test yielded P= 0.08. For performance accuracy, an aggregate Euclidean distance deviation from entry landmark on the pedicle and a similar deviation from the target landmark in the vertebral body yielded P=0.04 from a two sample t-test in which the rejected null hypothesis assumes no improvement in performance accuracy from the practice to the test sessions, and the alternative hypothesis assumes an improvement. Conclusions. The performance accuracy on the simulator was comparable to the accuracy reported in literature on recent retrospective evaluation of such placements. The failure rates indicated a minor drop from practice to test sessions, and also indicated a trend (P=0.08) towards learning retention resulting in improvement from practice to test sessions. The performance accuracy showed a 15% mean score improvement and over 50% reduction in standard deviation from practice to test. It showed evidence (P=0.04) of performance accuracy improvement from practice to test session. Post print version of article may differ from published version. The definitive version is available through Lippincott, Williams & Wilkins at DOI: 10.1227/NEU.0b013e31821954ed Luciano, C. J., Banerjee, P. P., Bellotte, B., Lemole, G. M., Jr., Oh, M., Charbel, F. T., & Roitberg, B. 2011. Learning retention of thoracic pedicle screw placement using a high-resolution augmented reality simulator with haptic feedback. Neurosurgery.2011 Sep;69(1 Suppl Operative):ons14-9; Thu, 01 Sep 2011 05:00:00 GMT http://hdl.handle.net/10027/8753 2011-09-01T05:00:00Z http://hdl.handle.net/10027/8550 Spontaneous disappearance of large herniated disk fragments Slavin, Konstantin V. NOTICE: this is the author’s version of a work that was accepted for publication in World Neurosurgery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in World Neurosurgery, Vol 77, Issue 1, Jan 2012. DOI: 10.1016/j.wneu.2011.06.045 Sun, 01 Jan 2012 06:00:00 GMT http://hdl.handle.net/10027/8550 2012-01-01T06:00:00Z http://hdl.handle.net/10027/8388 Going Past the Data for Temozolomide Villano, J. Lee; Letarte, Nathalie; Bressler, Linda R. The benefit of six cycles of adjuvant temozolomide was documented in a randomized phase III (EORTC‐NCIC CE.3) trial and this therapy, following combined temozolomide and radiation, is the standard of care for patients with newly diagnosed glioblastoma. We comment on the differences on length of adjuvant therapy in both clinical practice and national studies (e.g. RTOG 0825), usually doubling the length than in the EORTC/NCIC study, and relate to historic adjuvant trials for solid tumors. © 2012 by Springer Verlag, Cancer Chemotherapy and Pharmacology The original publication is available at www.springerlink.com DOI: 10.1007/s00280-011-1796-4 Sun, 01 Apr 2012 05:00:00 GMT http://hdl.handle.net/10027/8388 2012-04-01T05:00:00Z http://hdl.handle.net/10027/8316 Virtual reality training in neurosurgery: Review of current status and future applications Alaraj, Ali; Lemole, Michael G.; Finkle, Joshua H.; Yudkowsky, Rachel; Wallace, Adam; Luciano, Cristian; Banerjee, P. Pat; Rizzi, Silvio; Charbel, Fady T. Background : Over years, surgical training is changing and years of tradition are being challenged by legal and ethical concerns for patient safety, work hour restrictions, and the cost of operating room time. Surgical simulation and skill training offer an opportunity to teach and practice advanced techniques before attempting them on patients. Simulation training can be as straightforward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer. More advanced virtual reality (VR) simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. Methods : A PubMed review of the literature was performed for the MESH words "Virtual reality", "Augmented Reality", "Simulation", "Training," and "Neurosurgery". Relevant articles were retrieved and reviewed. A review of the literature was performed for the history, current status of VR simulation in neurosurgery. Results : Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and credential surgeons as technically competent. The number of published literature discussing the application of VR simulation in neurosurgery training has evolved over the last decade from data visualization, including stereoscopic evaluation to more complex augmented reality models. With the revolution of computational analysis abilities, fully immersive VR models are currently available in neurosurgery training. Ventriculostomy catheters insertion, endoscopic and endovascular simulations are used in neurosurgical residency training centers across the world. Recent studies have shown the coloration of proficiency with those simulators and levels of experience in the real world. Conclusion : Fully immersive technology is starting to be applied to the practice of neurosurgery. In the near future, detailed VR neurosurgical modules will evolve to be an essential part of the curriculum of the training of neurosurgeons. © 2011 Alaraj et al; This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: 10.4103/2152-7806.80117 Thu, 28 Apr 2011 05:00:00 GMT http://hdl.handle.net/10027/8316 2011-04-28T05:00:00Z