{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:39:19Z","timestamp":1787845159017,"version":"build-2784847793"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008375","name":"University of Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The goal of this study was to determine whether residents can be taught to place spinal pedicle screws in a virtual reality (VR) environment and if the results are comparable to conventional training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this pilot study, four neurosurgery residents with less than one year of experience in spine surgery performed three rounds of pedicle screw instrumentation from L1 to S1. Both groups performed the first instrumentation after self-instruction. Before the second instrumentation, one group had conventional training, which was instruction on a synthetic bone model, and the other group was trained in a virtual environment. For the last instrumentation, both groups had both trainings. After completion, screw placement was rated by a blinded reader according to the trajectory and integrity of the screw canal. For statistical analysis, we used logistic regression for individual variability with Firth\u2019s bias reduction method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After self-instruction 21\/48 (44%) screws were misplaced, 6 (25%) in the group before conventional training and 15 (64%) in the group before VR-training. Both trainings led to a significant reduction of screw misplacement, with only a single misplaced screw in the VR-training group (2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and none in the conventional training group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). In both groups, no significant difference was found regarding the misplacement rate from the first to the second training (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.19).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Training in a virtual reality environment for lumbosacral pedicle screw placement is associated with an easy learning curve. Comparable outcomes are observed with conventional training, however, definitive conclusions regarding the relative effectiveness of either approach will require validation in studies with larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00590-025-04611-y","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T12:57:32Z","timestamp":1765803452000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Is virtual reality training for lumbosacral freehand pedicle screw placement an alternative to conventional training?"],"prefix":"10.1007","volume":"36","author":[{"given":"Lukas","family":"Urbanschitz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Mandelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cordula","family":"Netzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Cattin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Sch\u00e4ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"4611_CR1","doi-asserted-by":"publisher","first-page":"113","DOI":"10.3171\/2012.5.SPINE11399","volume":"17","author":"BJ Shin","year":"2012","unstructured":"Shin BJ, James AR, Njoku IU, H\u00e4rtl R (2012) Pedicle screw navigation: a systematic review and meta-analysis of perforation risk for computer-navigated versus freehand insertion. 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To mitigate potential bias, he was not involved in the planning of the study and independent data analysis was conducted by a biostatistician.None of the authors received financial compensation or direct funding by another party. Artificial bones and surgical instruments, as well as a company representative were provided by Depuy Synthes (Johnson & Johnson) for the reason of training the residents with the implants. We were permitted to use the premises and VR headsets with the VR Software Specto 5.0.0. of Specto Medical\n                      \u00ae\n                      . Neither party was involved in the study design, collection, analysis, and interpretation of data, or writing of this paper. There aren\u2019t any restrictions regarding submitting the report for publication; or a statement declaring that the supporting source had no such involvement or restrictions regarding publication. Only Authors had access to the study data and the data was not provided to the companies. One of the co-authors is one of the founders of Specto Medical\n                      \u00ae\n                      . To mitigate potential bias, he was not involved in the planning of the study and independent data analysis was conducted by a biostatistician.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethics approval is legally not required as no human or animal specimen were used in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"46"}}