3D Printer Assisted Neurosurgical Training Models

Project no. 32406 · Status: Kapanmış · 2024

Summary

Expanding upon established surgical simulation methods, we developed a fused deposition modeling (FDM) three-dimensional (3D) printed model of the C1–T1 vertebra for posterior cervical foraminotomy training, featuring silicone-based neural elements, polyurethane foam-based ligaments, and polyethylene terephthalate glycol (PETG) vertebrae. This study evaluates the effectiveness of a cost-efficient 3D-printed training model designed to help neurosurgical residents acquire fundamental skills in endoscopic posterior cervical foraminotomy, addressing the technique's challenging learning curve and limited training resources. Eight neurosurgery residents with over 2 years of training each completed four training sessions on two randomly assigned cervical spine levels using the newly developed 3D-printed model. A simple plumbing endoscope was used for real-time operative visualization. In the total of 64 completed surgical levels, left-sided procedures showed significantly higher insufficient decompression rates than right-sided operations (25.0% vs 3.6%, p=0.002). However, overall complication rates between sides did not reach statistical significance (p=0.073). Surgical parameters demonstrated consistent performance across sides, with no significant differences in operative duration. The Brunner-Langer analysis revealed substantial improvements across sessions in surgery duration (mean time decreasing from 21:42 ± 2:15 to 6:33 ± 0:42 minutes, p=0.004) and total complications (mean decreasing from 2.1 ± 0.8 to 0.4 ± 0.5, p=0.007). While fluoroscopy timing showed marginal improvement (mean time decreasing from 2:12 ± 1:15 to 0:55 ± 0:23 minutes, p=0.057), the number of fluoroscopic images demonstrated a trend toward reduction. This novel 3D-printed cervical spine model provides a viable, low-cost option for neurosurgical training programs, helping residents develop essential endoscopic skills in a controlled setting. Facilitating early proficiency in posterior cervical foraminotomy, it can serve as a valuable intermediate step before transitioning to cadaveric models and clinical practice.

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