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Higher Body Fat Linked to Increased Back Pain

With further research, interventions to prevent increased fat mass may help to reduce the risks of back pain and related disability, according to the new study.

A task simulator with 3D and tactile feedback can provide neurosurgeons in training with valuable practice in developing essential surgical skills, suggests a study in the September issue of  Neurosurgeryofficial journal of the  Congress of Neurological Surgeons. The journal is published by  Lippincott Williams & Wilkins, a part of  Wolters Kluwer Health.

Christian J. Luciano, Ph.D., P. Pat Banerjee, Ph.D., both of University of Illinois at Chicago and colleagues designed a study to evaluate the use of a virtual reality system combining visual and haptic (tactile) feedback as a training tool for neurosurgeons. The technology provided trainees with the opportunity to practice a basic but critical neurosurgical skill: placing screws in vertebrae as part of surgery to stabilize the spine.

Practice on Virtual Reality System May Enhance Surgical Skills
The "ImmersiveTouch" virtual reality system provides real-time feedback to surgeons as they perform simulated procedures. The simulation was based on 3D computed tomography reconstructions of an actual patient. The system provides both visual and tactile feedback to make the experience as realistic as possible. For example, the simulated 3D view shifts in response to head movement. When the surgeon operates a virtual drill, the system provides resistance and vibration.

The study included 51 neurosurgery residents and fellows attending a national meeting. After five minutes of training on a practice model, the junior surgeons were tested on their ability to place a screw accurately through a vertebra. This maneuver—called pedicle screw placement—is an essential skill for every neurosurgeon, but one with a substantial learning curve.

The results showed a small reduction in the residents' failure rate: from 16.9 percent during practice sessions to 12.5 percent during the test session. Although below the accepted threshold for statistical significance, the improvement is "notable" and deserving of further study, according to Drs. Luciano, Banerjee and coauthors.

Given the short time allowed for practice, the researchers were surprised to see as much improvement in the test sessions as they did. If trainees were given the opportunity to perform extensive repetitions of the simulated procedure, even greater improvements in accuracy might be expected. The trainees found the 3D simulator faithfully represents the "real life" conditions encountered in screw placement.

The experiment was part of a series of studies using the ImmersiveTouch system to enhance neurosurgical training. The researchers are working to increase the "library of tasks" simulated for use in the virtual reality environment.

Drs. Luciano, Banerjee and colleagues note that the system can be adjusted to a variety of simulation settings, based on the preferences of trainees and teachers. With further development, they believe the ImmersiveTouch simulator will be useful in practicing and testing a wide range of surgical tasks—providing trainees with valuable experience in developing their skills.

About  Neurosurgery
Neurosurgerythe Official Journal of the  Congress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field,  Neurosurgery is nothing short of indispensable.

About Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the  LWW brand, as well as content-based sites and online corporate and customer services.

LWW is part of  Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of  Wolters Kluwer, a market-leading global information services company with 2010 annual revenues of €3.6 billion ($4.7 billion).