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Development and Evaluation of a Mixed Reality Training Platform for Graft Placement and Cage Insertion During Spinal Fusion.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Development and Evaluation of a Mixed Reality Training Platform for Graft Placement and Cage Insertion During Spinal Fusion./
Author:	Patel, Sneha.
Description:	1 online resource (171 pages)
Notes:	Source: Dissertations Abstracts International, Volume: 84-05, Section: A.
Contained By:	Dissertations Abstracts International84-05A.
Subject:	Kinematics. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30157820click for full text (PQDT)
ISBN:	9798352992012

Development and Evaluation of a Mixed Reality Training Platform for Graft Placement and Cage Insertion During Spinal Fusion.
Patel, Sneha.

Development and Evaluation of a Mixed Reality Training Platform for Graft Placement and Cage Insertion During Spinal Fusion. - 1 online resource (171 pages)

Source: Dissertations Abstracts International, Volume: 84-05, Section: A.

Thesis (Ph.D.)--McGill University (Canada), 2022.

Includes bibliographical references

Low back pain is globally considered the leading cause of disability. Spinal fusion is a surgical procedure used to treat low back pain caused by trauma or degenerative disorders, among other symptoms. New and evolving minimally invasive spinal fusion procedures are proposed based on the promised benefits of the technique. These however constrain surgeons due to smaller workspace and require training to successfully perform the procedure on patients.Virtual reality simulators show promise to train surgeons in complex surgical procedures. Within these simulators, the haptic feedback plays a key role as it provides essential information to the surgeons about the surgical area. To date no simulator offers the training of bone graft and spinal cage insertion. Thus, the global objective of this thesis was to develop a mixed reality physics based surgical simulator for spinal fusion with focus on bone graft and cage insertion steps. It was hypothesized that these surgical steps could be emulated in such a simulator. The thesis was divided into three objectives and corresponding hypotheses, presented as separate chapters herein.First, the configuration of the mixed reality simulator benchtop was important to designing the benchtop with the haptic device, position sensors, and surgical area model. The hypothesis was that a workflow could be utilized to determine the configuration of the benchtop in the simulator. Numerical analyses compared the workspaces of the haptic device and surgical procedure, and then determined the appropriate placement of all benchtop components. The determined configuration was then validated by experienced surgeons who first performed the procedure on a cadaver. Data indicated that the determined benchtop configuration and the associated workspace of the haptic device supported the workspace of the procedure.Second, force feedback experienced by surgeons during graft and cage insertion was collected. The hypothesis was that force based metrics used by surgeons was observed through the measured variables. Lumbar intervertebral discs from two cadavers were used to collect impact forces and displacements used to insert graft and cage. Average forces of 100 and 573N (standard deviation of 170N and 197N, respectively), and maximum displacements of 41.2 and 3.0 mm, were observed during graft and cage insertion, respectively. Based on the applied impact forces, it was determined that the haptic device was not suitable for relaying the feedback experienced in such surgical steps. Relationships were observed during graft and cage insertion for the observed variables. The data were then used to design, develop, and test novel analog impacting tools to be used with the simulator.Third, the developed analog impact tools for use during graft and cage insertion in the mixed reality simulator were validated based on quantitative and qualitative data collected during trials with orthopedic surgeons. The hypothesis was that the trends between the measured variables in the cadaver studies were modeled by the analog tools and the tools were deemed acceptable based on surgeon feedback. Tools were assessed using quantitative data collected using the methods outlined in the cadaver studies while using analog impact tools within the simulator. Furthermore, the tools were qualitatively assessed via surgeon feedback collected using questionnaires. The tools demonstrated the ability to model the relationships from the cadaver experiments 53% and 31% of the times for the two graft tool profiles. Other patterns for expert surgeons point to the use of varying techniques to complete the task. Based on the Likert scores it was determined that the assessed behaviors of the tools were acceptable suggesting an overall approval.To meet the haptic needs of orthopedic surgical training in a mixed reality simulator a benchtop configuration, cadaver force profiles and analog impacting tools were developed to model the expected behavior and associated metrics in the simulator.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2023

Mode of access: World Wide Web

ISBN: 9798352992012Subjects--Topical Terms:

571109
Kinematics.
Index Terms--Genre/Form:

542853
Electronic books.

Development and Evaluation of a Mixed Reality Training Platform for Graft Placement and Cage Insertion During Spinal Fusion.
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245 1 0 $a Development and Evaluation of a Mixed Reality Training Platform for Graft Placement and Cage Insertion During Spinal Fusion.
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500 $a Source: Dissertations Abstracts International, Volume: 84-05, Section: A.
500 $a Advisor: Driscoll, Mark.
502 $a Thesis (Ph.D.)--McGill University (Canada), 2022.
504 $a Includes bibliographical references
520 $a Low back pain is globally considered the leading cause of disability. Spinal fusion is a surgical procedure used to treat low back pain caused by trauma or degenerative disorders, among other symptoms. New and evolving minimally invasive spinal fusion procedures are proposed based on the promised benefits of the technique. These however constrain surgeons due to smaller workspace and require training to successfully perform the procedure on patients.Virtual reality simulators show promise to train surgeons in complex surgical procedures. Within these simulators, the haptic feedback plays a key role as it provides essential information to the surgeons about the surgical area. To date no simulator offers the training of bone graft and spinal cage insertion. Thus, the global objective of this thesis was to develop a mixed reality physics based surgical simulator for spinal fusion with focus on bone graft and cage insertion steps. It was hypothesized that these surgical steps could be emulated in such a simulator. The thesis was divided into three objectives and corresponding hypotheses, presented as separate chapters herein.First, the configuration of the mixed reality simulator benchtop was important to designing the benchtop with the haptic device, position sensors, and surgical area model. The hypothesis was that a workflow could be utilized to determine the configuration of the benchtop in the simulator. Numerical analyses compared the workspaces of the haptic device and surgical procedure, and then determined the appropriate placement of all benchtop components. The determined configuration was then validated by experienced surgeons who first performed the procedure on a cadaver. Data indicated that the determined benchtop configuration and the associated workspace of the haptic device supported the workspace of the procedure.Second, force feedback experienced by surgeons during graft and cage insertion was collected. The hypothesis was that force based metrics used by surgeons was observed through the measured variables. Lumbar intervertebral discs from two cadavers were used to collect impact forces and displacements used to insert graft and cage. Average forces of 100 and 573N (standard deviation of 170N and 197N, respectively), and maximum displacements of 41.2 and 3.0 mm, were observed during graft and cage insertion, respectively. Based on the applied impact forces, it was determined that the haptic device was not suitable for relaying the feedback experienced in such surgical steps. Relationships were observed during graft and cage insertion for the observed variables. The data were then used to design, develop, and test novel analog impacting tools to be used with the simulator.Third, the developed analog impact tools for use during graft and cage insertion in the mixed reality simulator were validated based on quantitative and qualitative data collected during trials with orthopedic surgeons. The hypothesis was that the trends between the measured variables in the cadaver studies were modeled by the analog tools and the tools were deemed acceptable based on surgeon feedback. Tools were assessed using quantitative data collected using the methods outlined in the cadaver studies while using analog impact tools within the simulator. Furthermore, the tools were qualitatively assessed via surgeon feedback collected using questionnaires. The tools demonstrated the ability to model the relationships from the cadaver experiments 53% and 31% of the times for the two graft tool profiles. Other patterns for expert surgeons point to the use of varying techniques to complete the task. Based on the Likert scores it was determined that the assessed behaviors of the tools were acceptable suggesting an overall approval.To meet the haptic needs of orthopedic surgical training in a mixed reality simulator a benchtop configuration, cadaver force profiles and analog impacting tools were developed to model the expected behavior and associated metrics in the simulator.
520 $a La fusion vertebrale est une intervention chirurgicale utilisee pour traiter la lombalgie causee par un traumatisme ou des troubles degeneratifs. Des procedures de fusion vertebrale evolutives et peu invasives sont proposees sur la base des avantages promis de la technique, mais elles contraignent les chirurgiens en raison de l'espace de travail plus petit necessitant ainsi une formation.Les simulateurs de realite virtuelle sont prometteurs pour former les chirurgiens aux procedures chirurgicales complexes. Au sein de ces simulateurs, le retour haptique joue un role cle pour fournir des informations essentielles sur la zone chirurgicale. A ce jour, aucun simulateur n'offre la formation a la greffe osseuse et a l'insertion de cage rachidienne. Ainsi, l'objectif global de cette these etait de developper un simulateur chirurgical base sur la physique en realite mixte pour les etapes d'insertion de greffe osseuse et de cage dans une chirurgie de fusion. Il a ete emis l'hypothese que ces etapes chirurgicales pourraient etre emulees dans un tel simulateur. La these a ete divisee en trois objectifs et hypotheses correspondantes, presentes ici dans des chapitres distincts.Premierement, la conception de la configuration du simulateur de realite mixte par rapport a ses composants. L'hypothese etait qu'un flux de travail pourrait etre utilise pour determiner la configuration de la paillasse dans le simulateur. Une comparaison des espaces de travail du dispositif haptique et de la procedure chirurgicale a determine le placement de tous les composants de la paillasse. La configuration a ensuite ete validee par des chirurgiens experimentes qui ont d'abord realise l'intervention sur un cadavre. Les donnees ont indique que la configuration et l'espace de travail determines du dispositif haptique etaient compatibles avec ceux de la procedure.Deuxiemement, le retour de force ressenti par les chirurgiens lors de l'insertion du greffon et de la cage a ete collecte. L'hypothese etait que les mesures basees sur la force utilisees par les chirurgiens etaient observees a travers les variables mesurees. Les forces d'impact et les deplacements pendant l'insertion du greffon et de la cage ont ete collectes a partir des disques intervertebraux lombaires de deux cadavres. Des forces moyennes de 100 et 573N et des deplacements maximaux de 41,2 et 3,0 mm ont ete observes lors de l'insertion du greffon et de la cage, respectivement. Sur la base des forces d'impact appliquees, le dispositif haptique n'a pas ete considere comme approprie pour relayer la retroaction. Les donnees ont ete utilisees pour concevoir, developper et tester de nouveaux outils d'impact analogiques pour le simulateur.Troisiemement, les outils d'impact analogiques developpes a utiliser lors de l'insertion du greffon et de la cage dans le simulateur de realite mixte ont ete valides sur la base des donnees recueillies lors des essais des chirurgiens. L'hypothese etait que les tendances entre les variables mesurees dans les etudes cadaveriques etaient modelisees par les outils analogiques et que les outils etaient juges acceptables dans les commentaires des chirurgiens. Les outils ont ete evalues a l'aide des methodes decrites dans les etudes cadaveriques tout en utilisant des outils d'impact analogiques dans le simulateur et les commentaires des chirurgiens a partir des questionnaires. Les outils ont modelise les relations a partir des experiences sur cadavres 53 % et 31 % des fois pour les deux profils d'outils de greffe. D'autres modeles indiquent l'utilisation de differentes techniques de chirurgien.Les scores de Likert suggerent une approbation globale des comportements evalues des outils. Les besoins haptiques de la formation chirurgicale orthopedique dans un simulateur de realite mixte ont ete satisfaits grace au developpement d'une configuration de paillasse, de profils de force cadaverique et d'outils d'impact analogiques.
533 $a Electronic reproduction. $b Ann Arbor, Mich. : $c ProQuest, $d 2023
538 $a Mode of access: World Wide Web
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