Resident Physician Cleveland Clinic Cleveland, Ohio, United States
Introduction: Surgical simulation is an attractive option for educating trainees on a variety of spine surgery techniques, especially less routine skills like lumbar durotomy repair. However, high costs and significant lead time required to obtain surgical simulators often restrict their routine use in most training programs. Recent advances in 3D printing technology have enabled the rapid production of low-cost surgical simulators. The goal of the present study was to assess the efficacy of a lumbar spine simulator for durotomy repair.
Methods: A 3D printed lumbar spine simulator for durotomy repair was developed by modifying an open-source model (SpineBox). Seven simulators were printed using acrylonitrile butadiene styrene (ABS) filament on a consumer-grade 3D printer (Bambu Lab P1S). Each simulator was outfitted with a penrose drain attached to normal saline bag with IV tubing to simulate the lumbar dura and two-inch upholstery foam to simulate the paraspinal musculature and soft tissues. Current neurosurgical trainees from a single institution were recruited to participate in a 1-hour session in which they were tasked with performing a water-tight closure of a 1 cm durotomy. All participants were surveyed anonymously prior to and after the simulation session.
Results: All seven spine models printed without failure taking on average 12.2 hours and approximately $7 of ABS filament per model. Fourteen current neurosurgical residents participated in the simulation session with only 7 (50%) reporting any prior experience repairing a lumbar durotomy. However, all residents successfully completed the simulated task. Exit survey results indicated that all residents (100%) agreed that the simulation was useful and expressed interest in participating in future simulation experiences.
Conclusion : Our study found that low-cost 3D printed lumbar spine simulators for durotomy repair could be produced reliably and current neurosurgical trainees found these simulators to be useful for surgical skill practice. The open-source simulator used in this study is currently accessible to any trainee or residency program with access to a 3D printer. Although further work is needed to demonstrate these surgical simulation experiences can improve trainee performance in non-simulated conditions, these preliminary results are encouraging that low-cost 3D printed models are useful and easily accessible for resident education.