Evaluating the efficacy of a cost-effective, fully three-dimensional-printed vertebra model for endoscopic spine surgery training for neurosurgical residents.

IF 2.3 Q2 ORTHOPEDICS
Asian Spine Journal Pub Date : 2024-10-01 Epub Date: 2024-10-22 DOI:10.31616/asj.2024.0288
Bilal Bahadır Akbulut, Mustafa Serdar Bölük, Hüseyin Biçeroğlu, Taşkın Yurtseven
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引用次数: 0

Abstract

Study design: A fused deposition modeling three-dimensional (3D)-printed model of the L4-5 vertebra for lumbar discectomy was designed. The model included separately printed dura mater, spinal cord, ligamentum flavum, intervertebral disc (from thermoplastic polyurethane), and bony structures (from polylactic acid), and the material cost approximately US$ 1 per model. A simple plumbing endoscope was used for visualization. Dura mater injury was assessed by painting two layers on the dura mater, which peeled off with trauma.

Purpose: Endoscopic spine surgery is a subject of high interest in neurosurgery given its minimally invasive nature; however, it has a steep learning curve. This study evaluated the effectiveness of a cost-efficient 3D-printed model when teaching this technique to neurosurgery residents.

Overview of literature: Only a few studies have investigated the efficacy of such a model.

Methods: Eight residents with >2 years of training participated. Residents performed the procedure bilaterally and twice at 1-week intervals.

Results: From the 32 surgeries, four were excluded because of facet removal (as it widened the surgical corridor), leaving 28 surgeries for analysis. Initial surgeries demonstrated a mean operation time of 21 minutes 18 seconds (standard deviation [SD], 2 minutes 32 seconds), which improved to a mean of 6 minutes 45 seconds (SD, 37 seconds) in the fourth surgery (F(3, 17)=19.18, p <0.0001), demonstrating a significant reduction in surgical time over successive surgeries. The median area with the paint removed decreased, from 161.80 (85.55-217.83) to 95.13 mm2 (12.62-160.54), (F(2.072, Inf)=2.04, p =0.128); however, this was not significant. Resident feedback indicated high satisfaction with the educational value of the model.

Conclusions: The developed fully 3D-printed model provides a viable and scalable option for neurosurgical training programs, enhancing the learning experience while maintaining low costs. This model may be an excellent stepping stone for learning lumbar spine endoscopy, acclimating to the two-dimensional view, progressing to cadaver models, and, eventually, independent surgery.

评估经济高效的全三维打印椎体模型在神经外科住院医师内窥镜脊柱手术培训中的功效。
研究设计:设计了用于腰椎间盘切除术的熔融沉积建模三维(3D)打印 L4-5 椎体模型。该模型包括单独打印的硬脑膜、脊髓、黄韧带、椎间盘(由热塑性聚氨酯制成)和骨结构(由聚乳酸制成),每个模型的材料成本约为 1 美元。使用简单的管道内窥镜进行观察。目的:内窥镜脊柱手术因其微创性而成为神经外科领域备受关注的课题,但其学习曲线非常陡峭。本研究评估了一种具有成本效益的 3D 打印模型在向神经外科住院医师传授该技术时的有效性:只有少数研究调查了这种模型的有效性:方法:8名接受过2年以上培训的住院医师参加了研究。结果:在 32 例手术中,4 例手术成功:在 32 例手术中,有 4 例手术因切除切面(扩大了手术走廊)而被排除在外,剩下 28 例手术供分析。最初手术的平均手术时间为 21 分 18 秒(标准差 [SD],2 分 32 秒),第四次手术的平均手术时间缩短至 6 分 45 秒(标准差,37 秒)(F(3, 17)=19.18, p):所开发的全三维打印模型为神经外科培训项目提供了一个可行且可扩展的选择,在保持低成本的同时增强了学习体验。该模型可能是学习腰椎内窥镜、适应二维视图、进阶到尸体模型以及最终独立手术的绝佳垫脚石。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
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