Developing a wire navigation simulator for pedicle screw placement in minimally invasive transforaminal lumbar interbody fusion

Simulation training provides an opportunity for surgeons to learn key skills in a safe environment. This is especially important for surgical procedures where mistakes have high consequences, such as working near the spinal cord. Wire navigation is a common orthopedic skill that spans many procedures. This paper presents the design steps taken to modify an existing simulator intended to train surgeons on hip wire navigation so that it can be used to train surgeons on placing a K-wire during a minimally invasive transforaminal lumbar fusion, or MIS-TLIF. The new design was able to accommodate several unique features of the MIS-TLIF task and successfully simulate placing the guide wire in the pedicle body. Results show that the simulator design functions normally even in the face of hammering needed to place the guide wire, a unique step in this procedure compared with other wire navigation procedures. Additional work remaining involves developing a training curriculum so that surgeons can benefit from this new tool.