• Léonard Swann Chatelain, Marc Khalifé, Guillaume Riouallon, Pierre Guigui, and Emmanuelle Ferrero.
• Department of Orthopedic Surgery, Hôpital Européen Georges Pompidou (HEGP), 20 Rue Leblanc, 75015, Paris, France. leonard.chatelain@gmail.com.
• Eur Spine J. 2023 Feb 1; 32 (2): 712717712-717.

PurposeSimulators for pedicle screws placement range from basic sawbones to virtual reality. Yet, they remain expensive and often require specific devices. No free online virtual simulator has yet been developed. The goal was to design a freely accessible Web-based simulator.MethodsThe computer simulator consisted of a lumbar spine, a red box hiding the pedicles and five pairs of screws. After inserting the screws, the red box was removed to assess their position. A validation study was conducted with 24 medical students randomized into a simulation and a control group. All had a basic course on pedicle screws. The 12 simulation group students performed two sessions on computer. All 24 students then conducted a final common step on sawbones. The number of misplaced screws, types of breaches, and simulation times were analyzed.ResultsIn the final sawbones simulation, 96 real screws were studied. Control group misplaced 50% of their screws compared with only 20.8% in the simulation group (p < 0.05). More careful, simulation group students were slower to insert their real screws. Over the two computer simulations, the rate of misplaced screws decreased (12.5% vs. 38.3%), showing a good handling of the simulator. Students were able to analyze and correct their pedicle breaches.ConclusionThis tool is the first free online lumbar pedicle screws simulator. Simulation helped students to better position the final real screws on sawbones. This project showed it was possible to create a free educational tool with no special equipment.Level Of EvidenceLevel 3.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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