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We equipped a ball-tipped pedicle probe with a 6-axis force\/torque sensor and a motion capture marker cluster. We simultaneously recorded the pose of the probe relative to the vertebra and measured the generated forces and torques during palpation. This allowed us replaying the recorded palpation movements in our simulator and to fine-tune the haptic rendering to approximate the measured forces and torques. In a second experiment, we asked two neurosurgeons to palpate a virtual version of the same vertebra in our simulator, while we logged the forces and torques sent to the haptic device.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the experiments with the real vertebra, the maximum measured force along the longitudinal axis of the probe was 7.78\u00a0N and the maximum measured bending torque was 0.13\u00a0Nm. In an offline simulation of the motion of the pedicle probe recorded during the palpation of a real pedicle screw tract, our approach generated forces and torques that were similar in magnitude and progression to the measured ones. When surgeons tested our simulator, the distributions of the computed forces and torques were similar to the measured ones; however, higher forces and torques occurred more frequently.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We demonstrated the suitability of direct visual and haptic volume rendering to simulate a specific surgical procedure. Our approach of fine-tuning the simulation by measuring the forces and torques that are prevalent while palpating a real vertebra produced promising results.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s11548-020-02258-0","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T17:32:19Z","timestamp":1600709539000},"page":"1797-1805","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Force quantification and simulation of pedicle screw tract palpation using direct visuo-haptic volume rendering"],"prefix":"10.1007","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3919-145X","authenticated-orcid":false,"given":"Esther I.","family":"Zoller","sequence":"first","affiliation":[]},{"given":"Bal\u00e1zs","family":"Faludi","sequence":"additional","affiliation":[]},{"given":"Nicolas","family":"Gerig","sequence":"additional","affiliation":[]},{"given":"Gregory F.","family":"Jost","sequence":"additional","affiliation":[]},{"given":"Philippe C.","family":"Cattin","sequence":"additional","affiliation":[]},{"given":"Georg","family":"Rauter","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2020,9,21]]},"reference":[{"issue":"5","key":"2258_CR1","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1007\/s00586-015-3853-x","volume":"24","author":"AA Aoude","year":"2015","unstructured":"Aoude AA, Fortin M, Figueiredo R, Jarzem P, Ouellet J, Weber MH (2015) Methods to determine pedicle screw placement accuracy in spine surgery: a systematic review. 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Cattin is owner and co-founder of Diffuse GmbH (Heimberg, Switzerland) that commercially distributes SpectoVR. B. Faludi is employed at Diffuse. G.\u00a0F. Jost is both co-author of this work and one of the two tested participants. E.\u00a0I. Zoller, N. Gerig, and G. Rauter declare that they have no conflicts of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was conducted according to the declaration of Helsinki and the law of Switzerland. A formal approval by the responsible ethics commission was not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}