It is important to avoid iatrogenic injuries of nerves and blood vessels during the pedicle screw insertion stage of posterior cervical spine decompression and fusion surgery. First, it is necessary to determine the length and angulation of the pedicle screws for safety and stability. Second, it is necessary to drill precise preparation holes for the pedicle screws using a pedicle probe. In this work, we developed a VR training system for pedicle screw planning and basic drilling skills. The VR system was built with a pen‐style haptic device and a head‐mounted display. Trainees used the haptic pen as a virtual pedicle probe. In order to simulate bone hardness and stress accumulation at the virtual pedicle probe tip in the virtual surgery, we developed a voxel‐based bone drilling simulator. To reduce the heavy load required for voxel processing, the simulator was constructed as a hybrid system that included a removal volume voxel model for drilling areas and a fixed polygonal mesh model for other areas. 3D models of a cervical spine were generated from CT scan images of a patient. This paper evaluated the system through a subjective evaluation by a specialist and via the training results for novice trainees. We discuss the evaluation results and training effectiveness with the simulator. © 2020 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC.

中文翻译：

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用于颈椎后路融合手术训练的VR模拟器的开发

重要的是在颈椎后路减压和融合手术的椎弓根螺钉插入阶段中避免神经和血管的医源性伤害。首先，为了安全和稳定，必须确定椎弓根螺钉的长度和角度。其次，有必要使用椎弓根探针钻出用于椎弓根螺钉的精确准备孔。在这项工作中，我们开发了一个用于椎弓根螺钉计划和基本钻孔技能的VR培训系统。VR系统由笔式触觉设备和头戴式显示器组成。受训人员使用触觉笔作为虚拟的椎弓根探针。为了在虚拟手术中模拟虚拟椎弓根探针尖端处的骨骼硬度和应力累积，我们开发了基于体素的骨骼钻孔模拟器。为了减少体素处理所需的重负荷，该模拟器被构造为一个混合系统，包括用于钻井区域的去除体素模型和用于其他区域的固定多边形网格模型。颈椎的3D模型是根据患者的CT扫描图像生成的。本文通过专家的主观评估以及针对新手学员的培训结果对系统进行了评估。我们讨论了模拟器的评估结果和培训效果。©2020日本电气工程师学会。由Wiley Periodicals LLC发布。本文通过专家的主观评估以及针对新手学员的培训结果对系统进行了评估。我们讨论了模拟器的评估结果和培训效果。©2020日本电气工程师学会。由Wiley Periodicals LLC发布。本文通过专家的主观评估以及针对新手学员的培训结果对系统进行了评估。我们讨论了模拟器的评估结果和培训效果。©2020日本电气工程师学会。由Wiley Periodicals LLC发布。