{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T16:52:19Z","timestamp":1782838339206,"version":"3.54.5"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background and Objective\u2003Learning a new technique in neurosurgery is a big challenge especially for trainees. In recent years, simulations and simulators got into the focus as a teaching tool. Our objective is to propose a simulator for placement of cortical bone trajectory (CBT) screws to improve results and reduce complications.<\/jats:p><jats:p>Methods\u2003We have created a platform consisting of a sawbone navigated with a 3D fluoroscope to familiarize our trainees and consultants with CBT technique and later implement it in our department. Objective Structured Assessment of Technical Skills (OSATS) and Physician Performance Diagnostic Inventory Scale (PPDI) were obtained before and after the use of the simulator by the five participants in the study. Patients who were operated on after the implementation of the technique were retrospectively reviewed.<\/jats:p><jats:p>Results\u2003During the simulation, there were 4 cases of pedicle breach out of 24 screws inserted (16.6%). After having completed simulation, participants demonstrated an improvement in OSATS and PPDI (p\u2009=\u20090.039 and 0.042, respectively). Analyzing the answers to the different items of the tests, participants mainly improved in the knowledge (p\u2009=\u20090.038), the performance (p\u2009=\u20090.041), and understanding of the procedure (p\u2009=\u20090.034). In our retrospective series, eight patients with L4\u2013L5 instability were operated on using CBT, improving their Oswestry Disability Index (ODI) score (preoperative ODI 58.5 [SD 16.7] vs. postoperative ODI 31 [SD 13.4]; p\u2009=\u20090.028). One intraoperative complication due to a dural tear was observed. In the follow-up, we found a case of pseudoarthrosis and a facet joint violation, but no other complications related to misplacement, pedicle fracture, or hardware failure.<\/jats:p><jats:p>Conclusion\u2003The simulation we have created is useful for the implementation of CBT. In our study, consultants and trainees have valued very positively the learning obtained using the system. Moreover, simulation facilitated the learning of the technique and the understanding of surgical anatomy. We hope that simulation helps reducing complications in the future.<\/jats:p>","DOI":"10.1055\/s-0040-1715485","type":"journal-article","created":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T00:48:46Z","timestamp":1606870126000},"page":"262-269","source":"Crossref","is-referenced-by-count":5,"title":["Simulation with 3D Neuronavigation for Learning Cortical Bone Trajectory Screw Placement"],"prefix":"10.1055","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4251-8356","authenticated-orcid":false,"given":"Juan","family":"Delgado-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery University Hospital 12 de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Frade-Porto","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University Hospital La Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Blasco","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University Hospital La Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Gonzalez-Tarno","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University Hospital La Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Gil-Simoes","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University Hospital La Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"Pulido","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University Hospital La Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.G.","family":"Sola","sequence":"additional","affiliation":[{"name":"Department of Innovation in Neurosurgery, Universidad Aut\u00f3noma de Madrid, Madrid, Spain"},{"name":"Neurosurgical Department Hospital Nuestra Se\u00f1ora del Rosario, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,12,1]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1161\/STROKEAHA.112.673228","article-title":"Intraventricular fibrinolysis does not increase perihemorrhagic edema after intracerebral hemorrhage","volume":"44","author":"B Volbers","year":"2013","journal-title":"Stroke"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3171\/2014.3.JNS132591","article-title":"Editorial: see one, simulate fifty, then do one?","volume":"121","author":"R L 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