Use of Augmented Reality in Learning Epidural Insertion in Scoliosis Patients: A Follow-up Study

Background: Epidural placement in patients with scoliosis is technically challenging due to the distorted anatomy, resulting in high failure rates. Traditional training modalities provide limited opportunities for repeated practice. Augmented reality (AR) offers immersive three-dimensional (3D) visualization that may enhance understanding and procedural planning. Materials and Methods: This was a single-center, observational, and exploratory study. Sixteen anesthesia trainees of varying grades participated. They completed a pre-intervention questionnaire on baseline experience and digital learning exposure. Participants then undertook an AR-based session using Microsoft HoloLens 2 with both normal and scoliotic spine models, followed by a structured post-intervention questionnaire comprising 25 Likert-scale items. Primary outcomes were perceived understanding of scoliotic anatomy and confidence in planning neuraxial procedures; secondary outcomes included perceived value of AR features and suggested improvements. Results: All participants completed both questionnaires without missing data. The mean anesthesia experience was 5.5 ± 3.2 years. While 93.8% had prior experience performing neuraxial blocks in scoliosis, only 25.0% had received specific training. Post-intervention, participants reported improved spatial understanding, enhanced engagement, and increased procedural confidence, with all learning-related items scoring a median of ≥4. Highly rated features included 3D rotation, anatomical clarity, and magnification. Suggested enhancements included adjustable spinal curvature, sequential anatomical layering, and integration of haptic feedback. Conclusion: AR improved trainees’ perceived comprehension of complex spinal anatomy and confidence in procedural planning. Although limited by a small sample size and subjective outcomes, AR represents a promising adjunct to traditional epidural training. Future studies should include larger samples, validated outcome measures, and integration of haptic feedback to strengthen educational impact.