Haptics in computer-mediated simulation: Training in vertebroplasty surgery

Surgical simulators and computer games share the enabling technologies in the human-machine interface. With appropriate design and development, the computer-game-like medical training simulator could be used in surgical training. The authors describe a PC-based system for the simulation of the vertebroplasty procedure. In vertebroplasty, the surgeon or radiologist relies on sight and feel to properly insert the bone needle through various tissue types and densities and monitor the injection and reflux of the polymethylmethacrylate (PMMA), or cement, into the vertebra. This article focuses on the provision of a near-realistic haptic feel in bone needle insertion and manual PMMA injection. This involves an efficient biomechanical modeling of bone needle insertion and PMMA flow in bone for haptic rendering, as well as reliable delivery of forces via haptic devices. The authors show that with virtual reality gaming technologies, the surgical simulator can become a virtual trainer for a potentially risky spinal interventional procedure.