{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T18:32:07Z","timestamp":1780338727907,"version":"3.54.1"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Mixed-reality simulation is an emerging tool for creating anatomical models for preoperative planning. Its use in neurosurgical training (NT) has been limited because of the difficulty in real-time interactive teaching. This study describes the development of a patient-specific, interactive mixed-reality NT system. The authors took cases of intracranial tumor resection or neurovascular compression (NVC) as examples to verify the technical feasibility and efficacy of the mixed-reality NT system for residents\u2019 training and preoperative planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This study prospectively enrolled 40 patients who suffered from trigeminal neuralgia, hemifacial spasms, or intracranial tumors. The authors used a series of software programs to process the multimodal imaging data, followed by uploading the holographic models online. They used a HoloLens or a standard iOS device to download and display the holographic models for training. Ten neurosurgical residents with different levels of surgical experience were trained with this mixed-reality NT system. Change in surgical strategy was recorded, and a questionnaire survey was conducted to evaluate the efficacy of the mixed-reality NT system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The system allows the trainer and trainee to view the mixed-reality model with either a HoloLens or an iPad\/iPhone simultaneously online at different locations. Interactive manipulation and instant updates were able to be achieved during training. A clinical efficacy validation test was conducted. The surgeons changed their exploration strategy in 48.3% of the NVC cases. For residents with limited experience in surgery, the exploration strategy for 75.0% of all patients with NVC was changed after the residents were trained with the mixed-reality NT system. Of the 60 responses for intracranial tumors, the trainee changed the surgical posture in 19 (31.7%) cases. The change of the location (p\n                      <jats:italic>=<\/jats:italic>\n                      0.0338) and size (p\n                      <jats:italic>=<\/jats:italic>\n                      0.0056) of craniotomy are significantly related to the experience of the neurosurgeons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The mixed-reality NT system is available for local or real-time remote neurosurgical resident training. It may effectively help neurosurgeons in patient-specific training and planning of surgery for cases of NVC and intracranial tumor. The authors expect the system to have a broader application in neurosurgery in the near future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.10.focus23622","type":"journal-article","created":{"date-parts":[[2023,12,31]],"date-time":"2023-12-31T23:50:04Z","timestamp":1704066604000},"page":"E15","source":"Crossref","is-referenced-by-count":8,"title":["A patient-specific, interactive, multiuser, online mixed-reality neurosurgical training and planning system"],"prefix":"10.3171","volume":"56","author":[{"given":"Jingyue","family":"Wang","sequence":"first","affiliation":[{"name":"Medical School of Chinese PLA, Beijing;"},{"name":"Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yining","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinghua","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangye","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA, Beijing;"},{"name":"Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhichao","family":"Gan","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA, Beijing;"},{"name":"Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruochu","family":"Xiong","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA, Beijing;"},{"name":"Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiashu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"World Neurosurg","first-page":"583","article-title":"Simulation in neurosurgery\u2014a brief review and commentary","volume":"89","author":"Cobb MI","year":"2016","unstructured":"Cobb MI, Taekman JM, Zomorodi AR, Gonzalez LF, Turner DA. Simulation in neurosurgery\u2014a brief review and commentary. World Neurosurg. 2016;89:583\u2013586."},{"issue":"suppl 1","key":"b2","series-title":"Neurosurgery","first-page":"154","article-title":"Virtual reality simulation in neurosurgery: technologies and evolution","volume":"72","author":"Chan S","year":"2013","unstructured":"Chan S, Conti F, Salisbury K, Blevins NH. Virtual reality simulation in neurosurgery: technologies and evolution. Neurosurgery. 2013;72(suppl 1):154-164."},{"key":"b3","series-title":"World Neurosurg","first-page":"20","article-title":"Shared objective mentorship via virtual research and education initiatives for medical students and residents in neurosurgery: a systematic review and methodological discussion of the Neurosurgery Education and Research Virtual Group experience","volume":"172","author":"Koller GM","year":"2023","unstructured":"Koller GM, Reardon T, Kortz MW,  Shared objective mentorship via virtual research and education initiatives for medical students and residents in neurosurgery: a systematic review and methodological discussion of the Neurosurgery Education and Research Virtual Group experience. World Neurosurg. 2023;172:20\u201333."},{"key":"b4","series-title":"Front Public Health","first-page":"8","article-title":"Regional disparity of medical resources and its effect on mortality rates in China","volume":"8","author":"Chai KC","year":"2020","unstructured":"Chai KC, Zhang YB, Chang KC. Regional disparity of medical resources and its effect on mortality rates in China. Front Public Health. 2020;8:8."},{"key":"b5","series-title":"World Neurosurg","first-page":"e669","article-title":"Quantifying the opportunity cost of neurosurgical resident education","volume":"175","author":"Venkatraman V","year":"2023","unstructured":"Venkatraman V, Suarez AD, Kirsch EP,  Quantifying the opportunity cost of neurosurgical resident education. World Neurosurg. 2023;175:e669\u2013e677."},{"issue":"4","key":"b6","series-title":"J Neurosurg","first-page":"1117","article-title":"The impact of a night float system on operative experience in neurosurgery residency","volume":"138","author":"Lazaro TT","year":"2022","unstructured":"Lazaro TT, Katlowitz KA, Karas PJ,  The impact of a night float system on operative experience in neurosurgery residency. J Neurosurg. 2022;138(4):1117\u20131123."},{"key":"b7","series-title":"World Neurosurg","first-page":"e683","article-title":"SimSpine: a cost-effective spinal endoscopy training prototype for neurosurgical residents skills training","volume":"173","author":"Bedi MS","year":"2023","unstructured":"Bedi MS, Raheja A, Katiyar V,  SimSpine: a cost-effective spinal endoscopy training prototype for neurosurgical residents skills training. World Neurosurg. 2023;173:e683\u2013e698."},{"issue":"4","key":"b8","series-title":"J Pediatr Surg","first-page":"675","article-title":"SuSiPed: an initial step towards a universal, low-cost, 3D-printable platform for pediatric minimal-invasive surgery training","volume":"58","author":"Weisser N","year":"2023","unstructured":"Weisser N, K\u00fcppers J, Lindner A, Heinrich M, Zimmermann P, Muensterer OJ. SuSiPed: an initial step towards a universal, low-cost, 3D-printable platform for pediatric minimal-invasive surgery training. J Pediatr Surg. 2023;58(4):675\u2013678."},{"issue":"2","key":"b9","series-title":"Oper Neurosurg (Hagerstown)","first-page":"e139","article-title":"Commentary: Physiological responses and training satisfaction during national rollout of a neurosurgical intraoperative catastrophe simulator for resident training","volume":"24","author":"Bouchal SM","year":"2023","unstructured":"Bouchal SM, Meyer JH, Bendok BR. Commentary: Physiological responses and training satisfaction during national rollout of a neurosurgical intraoperative catastrophe simulator for resident training. Oper Neurosurg (Hagerstown). 2023;24(2):e139\u2013e141."},{"issue":"6","key":"b10","series-title":"Anat Sci Educ","first-page":"525","article-title":"A meta-analysis of the educational effectiveness of three-dimensional visualization technologies in teaching anatomy","volume":"8","author":"Yammine K","year":"2015","unstructured":"Yammine K, Violato C. A meta-analysis of the educational effectiveness of three-dimensional visualization technologies in teaching anatomy. 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J Neurosurg. 2015;123(4):1070\u20131076."},{"issue":"1","key":"b15","series-title":"J Neurosurg Pediatr","first-page":"1","article-title":"Creation of a novel simulator for minimally invasive neurosurgery: fusion of 3D printing and special effects","volume":"20","author":"Weinstock P","year":"2017","unstructured":"Weinstock P, Rehder R, Prabhu SP, Forbes PW, Roussin CJ, Cohen AR. Creation of a novel simulator for minimally invasive neurosurgery: fusion of 3D printing and special effects. J Neurosurg Pediatr. 2017;20(1):1\u20139."},{"key":"b16","series-title":"World Neurosurg","first-page":"111","article-title":"Three-dimensional printing in neurosurgery residency training: a systematic review of the literature","volume":"161","author":"Blohm JE","year":"2022","unstructured":"Blohm JE, Salinas PA, Avila MJ, Barber SR, Weinand ME, Dumont TM. Three-dimensional printing in neurosurgery residency training: a systematic review of the literature. 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Neurosurg Focus. 2021;51(2):E22."},{"issue":"4","key":"b19","series-title":"J Neurosurg Sci","first-page":"491","article-title":"The use of mixed reality for the treatment planning of unruptured intracranial aneurysms","volume":"67","author":"Stifano V","year":"2023","unstructured":"Stifano V, Palumbo MC, Chidambaram S,  The use of mixed reality for the treatment planning of unruptured intracranial aneurysms. J Neurosurg Sci. 2023;67(4):491\u2013497."},{"key":"b20","series-title":"World Neurosurg","first-page":"e499","article-title":"Multimodal image-based virtual reality presurgical simulation and evaluation for trigeminal neuralgia and hemifacial spasm","volume":"113","author":"Yao S","year":"2018","unstructured":"Yao S, Zhang J, Zhao Y,  Multimodal image-based virtual reality presurgical simulation and evaluation for trigeminal neuralgia and hemifacial spasm. World Neurosurg. 2018;113:e499\u2013e507."},{"issue":"6","key":"b21","series-title":"Neurosurgery","first-page":"N11","article-title":"The Creation of Adam by Michelangelo Buonarroti (1475\u20131564)","volume":"59","author":"Salcman M","year":"2006","unstructured":"Salcman M. The Creation of Adam by Michelangelo Buonarroti (1475\u20131564). Neurosurgery. 2006;59(6):N11\u2013N12."},{"issue":"5","key":"b22","series-title":"Neurosurgery","first-page":"851","article-title":"Concealed neuroanatomy in Michelangelo\u2019s Separation of Light From Darkness in the Sistine Chapel","volume":"66","author":"Suk I","year":"2010","unstructured":"Suk I, Tamargo RJ. Concealed neuroanatomy in Michelangelo\u2019s Separation of Light From Darkness in the Sistine Chapel. Neurosurgery. 2010;66(5):851\u2013861."},{"issue":"11","key":"b23","series-title":"Acta Neurochir (Wien)","first-page":"2195","article-title":"Presurgical visualization of the neurovascular relationship in trigeminal neuralgia with 3D modeling using free Slicer software","volume":"158","author":"Han KW","year":"2016","unstructured":"Han KW, Zhang DF, Chen JG, Hou LJ. Presurgical visualization of the neurovascular relationship in trigeminal neuralgia with 3D modeling using free Slicer software. Acta Neurochir (Wien). 2016;158(11):2195\u20132201."},{"key":"b1","series-title":"World Neurosurg","first-page":"583","article-title":"Simulation in neurosurgery\u2014a brief review and commentary","volume":"89","author":"Cobb MI","year":"2016","unstructured":"Cobb MI, Taekman JM, Zomorodi AR, Gonzalez LF, Turner DA. Simulation in neurosurgery\u2014a brief review and commentary. 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Neurosurgery. 2013;72(suppl 1):154-164."},{"key":"b3","series-title":"World Neurosurg","first-page":"20","article-title":"Shared objective mentorship via virtual research and education initiatives for medical students and residents in neurosurgery: a systematic review and methodological discussion of the Neurosurgery Education and Research Virtual Group experience","volume":"172","author":"Koller GM","year":"2023","unstructured":"Koller GM, Reardon T, Kortz MW,  Shared objective mentorship via virtual research and education initiatives for medical students and residents in neurosurgery: a systematic review and methodological discussion of the Neurosurgery Education and Research Virtual Group experience. 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World Neurosurg. 2023;175:e669\u2013e677."},{"issue":"4","key":"b6","series-title":"J Neurosurg","first-page":"1117","article-title":"The impact of a night float system on operative experience in neurosurgery residency","volume":"138","author":"Lazaro TT","year":"2022","unstructured":"Lazaro TT, Katlowitz KA, Karas PJ,  The impact of a night float system on operative experience in neurosurgery residency. J Neurosurg. 2022;138(4):1117\u20131123."},{"key":"b7","series-title":"World Neurosurg","first-page":"e683","article-title":"SimSpine: a cost-effective spinal endoscopy training prototype for neurosurgical residents skills training","volume":"173","author":"Bedi MS","year":"2023","unstructured":"Bedi MS, Raheja A, Katiyar V,  SimSpine: a cost-effective spinal endoscopy training prototype for neurosurgical residents skills training. World Neurosurg. 2023;173:e683\u2013e698."},{"issue":"4","key":"b8","series-title":"J Pediatr Surg","first-page":"675","article-title":"SuSiPed: an initial step towards a universal, low-cost, 3D-printable platform for pediatric minimal-invasive surgery training","volume":"58","author":"Weisser N","year":"2023","unstructured":"Weisser N, K\u00fcppers J, Lindner A, Heinrich M, Zimmermann P, Muensterer OJ. SuSiPed: an initial step towards a universal, low-cost, 3D-printable platform for pediatric minimal-invasive surgery training. J Pediatr Surg. 2023;58(4):675\u2013678."},{"issue":"2","key":"b9","series-title":"Oper Neurosurg (Hagerstown)","first-page":"e139","article-title":"Commentary: Physiological responses and training satisfaction during national rollout of a neurosurgical intraoperative catastrophe simulator for resident training","volume":"24","author":"Bouchal SM","year":"2023","unstructured":"Bouchal SM, Meyer JH, Bendok BR. Commentary: Physiological responses and training satisfaction during national rollout of a neurosurgical intraoperative catastrophe simulator for resident training. Oper Neurosurg (Hagerstown). 2023;24(2):e139\u2013e141."},{"issue":"6","key":"b10","series-title":"Anat Sci Educ","first-page":"525","article-title":"A meta-analysis of the educational effectiveness of three-dimensional visualization technologies in teaching anatomy","volume":"8","author":"Yammine K","year":"2015","unstructured":"Yammine K, Violato C. A meta-analysis of the educational effectiveness of three-dimensional visualization technologies in teaching anatomy. Anat Sci Educ. 2015;8(6):525\u2013538."},{"issue":"3","key":"b11","series-title":"Anat Sci Educ","first-page":"353","article-title":"Neuroanatomy learning: augmented reality vs. cross-sections","volume":"13","author":"Henssen DJHA","year":"2020","unstructured":"Henssen DJHA, van den Heuvel L, De Jong G,  Neuroanatomy learning: augmented reality vs. cross-sections. Anat Sci Educ. 2020;13(3):353\u2013365."},{"issue":"5","key":"b12","series-title":"J Surg Educ","first-page":"762","article-title":"Use of 3-dimensional printing technology and silicone modeling in surgical simulation: development and face validation in pediatric laparoscopic pyeloplasty","volume":"71","author":"Cheung CL","year":"2014","unstructured":"Cheung CL, Looi T, Lendvay TS, Drake JM, Farhat WA. Use of 3-dimensional printing technology and silicone modeling in surgical simulation: development and face validation in pediatric laparoscopic pyeloplasty. J Surg Educ. 2014;71(5):762\u2013767."},{"key":"b13","series-title":"World Neurosurg","first-page":"668","article-title":"Using 3D printing to create personalized brain models for neurosurgical training and preoperative planning","volume":"90","author":"Ploch CC","year":"2016","unstructured":"Ploch CC, Mansi CSSA, Jayamohan J, Kuhl E. Using 3D printing to create personalized brain models for neurosurgical training and preoperative planning. World Neurosurg. 2016;90:668\u2013674."},{"issue":"4","key":"b14","series-title":"J Neurosurg","first-page":"1070","article-title":"Development of a 3D-printed external ventricular drain placement simulator: technical note","volume":"123","author":"Tai BL","year":"2015","unstructured":"Tai BL, Rooney D, Stephenson F,  Development of a 3D-printed external ventricular drain placement simulator: technical note. J Neurosurg. 2015;123(4):1070\u20131076."},{"issue":"1","key":"b15","series-title":"J Neurosurg Pediatr","first-page":"1","article-title":"Creation of a novel simulator for minimally invasive neurosurgery: fusion of 3D printing and special effects","volume":"20","author":"Weinstock P","year":"2017","unstructured":"Weinstock P, Rehder R, Prabhu SP, Forbes PW, Roussin CJ, Cohen AR. Creation of a novel simulator for minimally invasive neurosurgery: fusion of 3D printing and special effects. J Neurosurg Pediatr. 2017;20(1):1\u20139."},{"key":"b16","series-title":"World Neurosurg","first-page":"111","article-title":"Three-dimensional printing in neurosurgery residency training: a systematic review of the literature","volume":"161","author":"Blohm JE","year":"2022","unstructured":"Blohm JE, Salinas PA, Avila MJ, Barber SR, Weinand ME, Dumont TM. Three-dimensional printing in neurosurgery residency training: a systematic review of the literature. World Neurosurg. 2022;161:111\u2013122."},{"issue":"3","key":"b17","series-title":"J Craniofac Surg","first-page":"940","article-title":"The potential value of mixed reality in neurosurgery","volume":"32","author":"Zhang C","year":"2021","unstructured":"Zhang C, Gao H, Liu Z, Huang H. The potential value of mixed reality in neurosurgery. J Craniofac Surg. 2021;32(3):940\u2013943."},{"issue":"2","key":"b18","series-title":"Neurosurg Focus","first-page":"E22","article-title":"Holographic mixed-reality neuronavigation with a head-mounted device: technical feasibility and clinical application","volume":"51","author":"Qi Z","year":"2021","unstructured":"Qi Z, Li Y, Xu X,  Holographic mixed-reality neuronavigation with a head-mounted device: technical feasibility and clinical application. Neurosurg Focus. 2021;51(2):E22."},{"issue":"4","key":"b19","series-title":"J Neurosurg Sci","first-page":"491","article-title":"The use of mixed reality for the treatment planning of unruptured intracranial aneurysms","volume":"67","author":"Stifano V","year":"2023","unstructured":"Stifano V, Palumbo MC, Chidambaram S,  The use of mixed reality for the treatment planning of unruptured intracranial aneurysms. J Neurosurg Sci. 2023;67(4):491\u2013497."},{"key":"b20","series-title":"World Neurosurg","first-page":"e499","article-title":"Multimodal image-based virtual reality presurgical simulation and evaluation for trigeminal neuralgia and hemifacial spasm","volume":"113","author":"Yao S","year":"2018","unstructured":"Yao S, Zhang J, Zhao Y,  Multimodal image-based virtual reality presurgical simulation and evaluation for trigeminal neuralgia and hemifacial spasm. 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