Tag: neurosurgical education

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Disruptive technologies in spine surgery: current trends, outcomes, and ethical implications

J Neurosurg Spine 44:756–768, 2026

Disruptive technologies in spine surgery—AR/VR, robotics, neuronavigation, endoscopy, and patient-specific implants—are examined for their roles in enhancing precision, training, and patient outcomes. The review summarizes evidence for preoperative simulation, AR-assisted planning, and 3D segmentation, highlighting improvements in accuracy, reduced fluoroscopy, and trainee confidence.

Intraoperative advances such as robot-assisted techniques, computer-assisted navigation, and endoscopic approaches offer minimally invasive alternatives with favorable recovery profiles but face challenges of cost, learning curves, and equitable access. The authors emphasize ethical considerations, need for standardized outcomes, and strategies to expand accessibility and training.

Scope Disruptive spine-surgery technologies emphasized include AR/VR (XR), advanced navigation, robotics, patient-specific implants/3D printing, and endoscopic spine surgery.

XR definitions VR provides a fully immersive digital environment, AR overlays digital content onto the real world, and MR blends both; all fall under XR.

Training impact VR simulation in spine training improved trainee comfort and autonomy and reduced fluoroscopy use in lateral lumbar interbody fusion simulations; VR-trained learners also made fewer pedicle-screw placement errors than traditional instruction.

Preop planning VR-based planning can reduce fluoroscopy/localization time and improve puncture accuracy in endoscopic lumbar discectomy; segmented 3D models support rehearsal, trajectory planning, and risk assessment around critical structures.

AR navigation outcomes Wearable AR navigation (e.g., FDA-cleared xvision) has shown high pedicle-screw placement accuracy (reported ~96.7% thoracic and ~99.1% lumbosacral) and may reduce operative time and radiation exposure.

Patient-specific surgery Segmentation + 3D printing/predictive modeling enable personalized approaches and implants (e.g., patient-specific rods, templates, custom cages), with early reports of high accuracy for template-guided instrumentation and promising feasibility for custom interbody devices.

Endoscopic techniques ESS supports minimally invasive treatment across multiple pathologies and can match conventional outcomes for lumbar disc herniation while improving recovery (e.g., shorter stays/earlier return to work), but broader adoption is constrained by learning curve and reimbursement challenges.

Implementation ethics/costs High acquisition/maintenance costs and limited reimbursement risk widening access disparities; recommended mitigations include subsidized training, shared equipment models, and reimbursement policies to support equitable implementation alongside standardized outcomes and training.

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Evaluating the impact of a hand-crafted 3D-Printed head Model and virtual reality in skull base surgery training

Brain and Spine 5 (2025) 104163

A multimodal neurosurgical training course integrating hand-crafted 3D-printed head models, virtual reality, and cadaveric dissections significantly improved trainees’ anatomical understanding and surgical skills in skull base surgery. While offering a cost-effective, accessible alternative to cadaveric training, further refinement in soft tissue realism is needed.

• A hand-crafted 3D-printed head model and virtual reality (VR) were evaluated for skull base surgery training.

• A two-day course with 12 neurosurgical trainees and 11 faculty combined lectures, VR, cadaveric dissections, and hands-on practice with the 3D-printed model.

• The 3D model included four different skull base tumors and realistic neuroanatomy, assembled using patient imaging data and various materials.

• Trainees showed significant improvement in spatial understanding and knowledge of surgical steps after the course.

• Faculty and trainees rated the educational value and anatomical accuracy of the model highly, though soft tissue realism was rated lower.

• VR was found to enhance anatomical comprehension and surgical planning, complementing traditional methods.

• The approach offers a cost-effective, accessible alternative to cadaveric training, but further refinement in soft tissue simulation is needed.

• Study limitations include small sample size, subjective assessments, and lack of long-term outcome data.

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Artificial intelligence as a modality to enhance the readability of neurosurgical literature for patients

J Neurosurg 142:1189–1195, 2025

The study evaluates ChatGPT 3.5 and GPT4’s ability to generate readable, accurate summaries of neurosurgical literature, enhancing patient comprehension. GPT4 showed higher readability and accuracy, suggesting its potential in improving patient education and bridging the gap between medical findings and public understanding.

Study Overview

• Objective: Assess ChatGPT’s ability to generate readable, accurate neurosurgical summaries.

• Methods: Analyzed 150 abstracts from top neurosurgical journals.

• Models Used: GPT3.5 and GPT4.

Findings

• Readability Improvement: GPT4 summaries more readable than original abstracts.

• Scientific Accuracy: 84.2% of GPT4 summaries maintained moderate accuracy.

• Readability Metrics: GPT4 outperformed GPT3.5 in multiple readability scores.

Implications

• Patient Education: GPT4 can enhance neurosurgical literature comprehension for patients.

• Health Literacy: Potential to improve health literacy nationwide.

Limitations and Future Research

• Accessibility: GPT4’s restricted access limits broader application.

• Future Studies: Explore GPT4’s use in other medical specialties.

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Development and validation of the Skills Assessment in Microsurgery for Brain Aneurysms (SAMBA) instrument for predicting proficiency in aneurysm surgery

J Neurosurg 133:190–196, 2020

Surgical performance evaluation was first described with the OSATS (Objective Structured Assessment of Technical Skills) and modified for aneurysm microsurgery simulation with the OSAACS (Objective Structured Assessment of Aneurysm Clipping Skills). These methods rely on the subjective opinions of evaluators, however, and there is a lack of objective evaluation for proficiency in the microsurgical treatment of brain aneurysms.

The authors present a new instrument, the Skill Assessment in Microsurgery for Brain Aneurysms (SAMBA) scale, which can be used similarly in a simulation model and in the treatment of unruptured middle cerebral artery (MCA) aneurysms to predict surgical performance; the authors also report on its validation.

METHODS The SAMBA scale was created by consensus among 5 vascular neurosurgeons from 2 different neurosurgical departments. SAMBA results were analyzed using descriptive statistics, Cronbach’s alpha indexes, and multivariate ANOVA analyses (p < 0.05).

RESULTS Expert, intermediate-level, and novice surgeons scored, respectively, an average of 33.9, 27.1, and 16.4 points in the real surgery and 33.3, 27.3, and 19.4 points in the simulation. The SAMBA interrater reliability index was 0.995 for the real surgery and 0.996 for the simulated surgery; the intrarater reliability was 0.983 (Cronbach’s alpha). In both the simulation and the real surgery settings, the average scores achieved by members of each group (expert, intermediate level, and novice) were significantly different (p < 0.001). Scores among novice surgeons were more diverse (coefficient of variation = 12.4).

CONCLUSIONS Predictive validation of the placenta brain aneurysm model has been previously reported, but the SAMBA scale adds an objective scoring system to verify microsurgical ability in this complex operation, stratifying proficiency by points. The SAMBA scale can be used as an interface between learning and practicing, as it can be applied in a safe and controlled environment, such as is provided by a placenta model, with similar results obtained in real surgery, predicting real surgical performance.

 

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