Application of 3D printed lumbar puncture models in orthopedic clinical teaching_West China Medical Journal

Authors：

YUAN Dechao ¹ ,  WU Chao ^1,2 , DENG Jiayan ² , LIN Xu ¹ , TAN Lun ¹ , WANG Xiangyu ¹ , WANG Wei ³ , LUO Min ³

1. Section I, Department of Orthopaedics, the Fourth People’s Hospital of Zigong, Zigong, Sichuan 643000, P. R. China;
2. Digital Medical Center, the Fourth People’s Hospital of Zigong, Zigong, Sichuan 643000, P. R. China;
3. Department of Radiology, the Fourth People’s Hospital of Zigong, Zigong, Sichuan 643000, P. R. China;

Corresponding?author：

WU Chao, Email: flightiness@163.com

Keywords：

3D printing technology; Surgical model; Clinical teaching; Pedicle screw

DOI：

10.7507/1002-0179.201907230

Video：

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Objective To explore the feasibility of lumbar puncture models based on 3D printing technology for training junior orthopaedic surgeons to find the optimal pedicle screw insertion points.Methods Mimics software was used to design 3D models of lumbar spine with the optimal channels and alternative channels. Then, the printed lumbar spine models, plasticine, and cloth were used to build lumbar puncture models. From January 2018 to June 2019, 43 orthopedic trainees performed simulated operations to search for the insertion points of pedicle screws base on the models. The operations were performed once a day for 10 consecutive days, and the differences in operation scores and operation durations of the trainees among the 10 days were compared.Results All the trainees completed the surgical training operations successfully, and there were significant differences in the operation scores (13.05±2.45, 14.02±3.96, 17.58±3.46, 21.02±2.04, 23.40±4.08, 25.14±3.72, 27.26±6.09, 33.37±4.23, 35.00±4.15, 38.49±1.70; F=340.604, P<0.001) and operation durations [(22.51±4.28), (19.93±4.28), (18.05±2.89), (17.05±1.76), (16.98±1.97), (15.47±1.74), (13.51±1.42), (12.60±2.17), (12.44±1.71), (11.91±1.87) minutes; F=102.359, P<0.001] among the 10 days.Conclusion The 3D models of lumbar puncture are feasible and repeatable, which can contribute to surgical training.

Citation： YUAN Dechao, WU Chao, DENG Jiayan, LIN Xu, TAN Lun, WANG Xiangyu, WANG Wei, LUO Min. Application of 3D printed lumbar puncture models in orthopedic clinical teaching. West China Medical Journal, 2019, 34(9): 999-1004. doi: 10.7507/1002-0179.201907230 Copy

1.	Cha JR, Kim YC, Jang C, et al. Pedicle screw fixation and posterior fusion for lumbar degenerative diseases: effects on individual paraspinal muscles and lower back pain; a single-center, prospective study. BMC Musculoskelet Disord, 2016, 17(1).
2.	Lopez G, Wright R, Martin D, et al. A cost-effective junior resident training and assessment simulator for orthopaedic surgical skills via fundamentals of orthopaedic surgery. J Bone Joint Surg Am, 2015, 97A(8): 659-666.
3.	Garg B, Mehta N. Current status of 3d printing in spine surgery. J Clin Orthop Trauma, 2018, 9(3): 218-225.
4.	Hsu MR, Haleem MS, Hsu W. 3D printing applications in minimally invasive spine surgery. Minim Invasive Surg, 2018, 2018: 4760769.
5.	陽宏奇, 雷青, 蔡立宏, 等. 3D打印導板輔助空心螺釘內固定治療不穩定性骨盆骨折. 中國修復重建外科雜志, 2018, 32(2): 145-151.
6.	石維祥, 羅曉中, 吳剛, 等. 3D打印技術在內外踝尖部撕脫骨折治療中的應用. 中國修復重建外科雜志, 2018, 32(2): 187-191.
7.	Jones DB, Sung R, Weinberg C, et al. Three-dimensional modeling may improve surgical education and clinical practice. Surg Innov, 2016, 23(2): 189-195.
8.	杜良杰, 李建軍. 國人成年男性胸腰椎椎弓根徑線和偏角與脊椎節段序數的相關性研究. 中國脊柱脊髓雜志, 2009, 19(7): 545-549.
9.	王碧菠, 陳博, 李星辰, 等. 3D打印距骨部件修復重建距骨病損的生物力學研究. 中國修復重建外科雜志, 2018, 32(3): 306-310.
10.	Wu AM, Lin JL, Kwan KY, et al. 3D-printing techniques in spine surgery: the future prospects and current challenges. Expert Rev Med Devices, 2018, 15(6): 399-401.
11.	Park HJ, Wang C, Choi KH, et al. Use of a life-size three-dimensional-printed spine model for pedicle screw instrumentation training. J Orthop Surg Res, 2018, 13(1).
12.	Burkhard M, Fürnstahl P, Farshad M. Three-dimensionally printed vertebrae with different bone densities for surgical training. Eur Spine J, 2018.
13.	李明, 孫亮, 馬騰, 等. 3d打印快速成型技術在髖臼骨折分型及年輕醫生培養中的應用. 中華創傷骨科雜志, 2017, 19(2): 140-145.
14.	Bohl MA, Mooney MA, Repp GJ, et al. The barrow biomimetic spine fluoroscopic analysis of a synthetic spine model made of variable 3D-printed materials and print parameters. Spine (Phila Pa 1976), 2018, 43(23): E1368-E1375.
15.	Cramer J, Quigley E, Hutchins T, et al. Educational material for 3D visualization of spine procedures: methods for creation and dissemination. J Digit Imaging, 2017, 30(3): 296-300.
16.	黃國秀, 譚海濤. 3D打印模型在椎間孔鏡手術教學中的應用進展. 中國醫學教育技術, 2017, 31(4): 460-464.

1. Cha JR, Kim YC, Jang C, et al. Pedicle screw fixation and posterior fusion for lumbar degenerative diseases: effects on individual paraspinal muscles and lower back pain; a single-center, prospective study. BMC Musculoskelet Disord, 2016, 17(1).
2. Lopez G, Wright R, Martin D, et al. A cost-effective junior resident training and assessment simulator for orthopaedic surgical skills via fundamentals of orthopaedic surgery. J Bone Joint Surg Am, 2015, 97A(8): 659-666.
3. Garg B, Mehta N. Current status of 3d printing in spine surgery. J Clin Orthop Trauma, 2018, 9(3): 218-225.
4. Hsu MR, Haleem MS, Hsu W. 3D printing applications in minimally invasive spine surgery. Minim Invasive Surg, 2018, 2018: 4760769.
5. 陽宏奇, 雷青, 蔡立宏, 等. 3D打印導板輔助空心螺釘內固定治療不穩定性骨盆骨折. 中國修復重建外科雜志, 2018, 32(2): 145-151.
6. 石維祥, 羅曉中, 吳剛, 等. 3D打印技術在內外踝尖部撕脫骨折治療中的應用. 中國修復重建外科雜志, 2018, 32(2): 187-191.
7. Jones DB, Sung R, Weinberg C, et al. Three-dimensional modeling may improve surgical education and clinical practice. Surg Innov, 2016, 23(2): 189-195.
8. 杜良杰, 李建軍. 國人成年男性胸腰椎椎弓根徑線和偏角與脊椎節段序數的相關性研究. 中國脊柱脊髓雜志, 2009, 19(7): 545-549.
9. 王碧菠, 陳博, 李星辰, 等. 3D打印距骨部件修復重建距骨病損的生物力學研究. 中國修復重建外科雜志, 2018, 32(3): 306-310.
10. Wu AM, Lin JL, Kwan KY, et al. 3D-printing techniques in spine surgery: the future prospects and current challenges. Expert Rev Med Devices, 2018, 15(6): 399-401.
11. Park HJ, Wang C, Choi KH, et al. Use of a life-size three-dimensional-printed spine model for pedicle screw instrumentation training. J Orthop Surg Res, 2018, 13(1).
12. Burkhard M, Fürnstahl P, Farshad M. Three-dimensionally printed vertebrae with different bone densities for surgical training. Eur Spine J, 2018.
13. 李明, 孫亮, 馬騰, 等. 3d打印快速成型技術在髖臼骨折分型及年輕醫生培養中的應用. 中華創傷骨科雜志, 2017, 19(2): 140-145.
14. Bohl MA, Mooney MA, Repp GJ, et al. The barrow biomimetic spine fluoroscopic analysis of a synthetic spine model made of variable 3D-printed materials and print parameters. Spine (Phila Pa 1976), 2018, 43(23): E1368-E1375.
15. Cramer J, Quigley E, Hutchins T, et al. Educational material for 3D visualization of spine procedures: methods for creation and dissemination. J Digit Imaging, 2017, 30(3): 296-300.
16. 黃國秀, 譚海濤. 3D打印模型在椎間孔鏡手術教學中的應用進展. 中國醫學教育技術, 2017, 31(4): 460-464.

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