An immersive mixed reality surgical self-training system for precise pedicle screw placement: a randomized controlled trial

作者：Qian He, Jiahao Li, Ye Xiao, Jingjing Tian, Ningbo Mao, Sheng Lü, Yu Zhang, Yu Zhao · 发表于：BMC Medical Education · 年份：2025 · DOI：10.1186/s12909-025-07978-y · 被引用次数：4 · 研究领域：Surgical Simulation and Training、Spinal Fractures and Fixation Techniques、Augmented Reality Applications

BACKGROUND: Given the long and costly training cycle required for pedicle screw placement, we proposed an immersive mixed reality surgical self-training system (IMR-SS) for pedicle screw placement. IMR-SS combines holographic real-time training instructions with a physical spine phantom to integrate virtual simulation with hands-on training. This study evaluated the effectiveness of IMR-SS in a randomized controlled trial. We aimed to determine whether IMR-SS improves novice learners' pedicle screw placement performance and training satisfaction. METHODS: The IMR-SS for pedicle screwing consists of three parts: a teaching module, a hands-on module, and an assessment module. The IMR-SS integrates 3D-printed models, real surgical instruments, and immersive mixed reality technology to provide an immersive learning experience, high-fidelity haptic feedback, and real-time instructions. A randomized controlled trial was conducted with 32 undergraduate medical students from two centers. Participants were randomly assigned to either the IMR group (using IMR-SS) or the control group (using a digital textbook). Both groups underwent theoretical and practical training, followed by identical assessments. RESULTS: Compared with the control group, the IMR group presented significantly higher completion rates (0.99 ± 0.02 vs. 0.87 ± 0.11, p < 0.01) and fewer errors (0.06 ± 0.25 vs. 2.13 ± 1.54, p < 0.01). The IMR group showed better performance with significantly smaller screw placement ang...