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

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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.	阳宏奇, 雷青, 蔡立宏, 等. 3D打印导板辅助空心螺钉内固定治疗不稳定性骨盆骨折. 中国修复重建外科杂志, 2018, 32(2): 145-151.
6.	石维祥, 罗晓中, 吴刚, 等. 3D打印技术在内外踝尖部撕脱骨折治疗中的应用. 中国修复重建外科杂志, 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, 李建军. 国人成年男性胸腰椎椎弓根径线和偏角与脊椎节段序数的相关性研究. 中国脊柱脊髓杂志, 2009, 19(7): 545-549.
9.	王碧菠, 陈博, 李星辰, 等. 3D打印距骨部件修复重建距骨病损的生物力学研究. 中国修复重建外科杂志, 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, 孙亮, 马腾, 等. 3d打印快速成型技术在髋臼骨折分型及年轻医生培养中的应用. 中华创伤骨科杂志, 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.	黄国秀, 谭海涛. 3D打印模型在椎间孔镜手术教学中的应用进展. 中国医学教育技术, 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. 阳宏奇, 雷青, 蔡立宏, 等. 3D打印导板辅助空心螺钉内固定治疗不稳定性骨盆骨折. 中国修复重建外科杂志, 2018, 32(2): 145-151.
6. 石维祥, 罗晓中, 吴刚, 等. 3D打印技术在内外踝尖部撕脱骨折治疗中的应用. 中国修复重建外科杂志, 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, 李建军. 国人成年男性胸腰椎椎弓根径线和偏角与脊椎节段序数的相关性研究. 中国脊柱脊髓杂志, 2009, 19(7): 545-549.
9. 王碧菠, 陈博, 李星辰, 等. 3D打印距骨部件修复重建距骨病损的生物力学研究. 中国修复重建外科杂志, 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, 孙亮, 马腾, 等. 3d打印快速成型技术在髋臼骨折分型及年轻医生培养中的应用. 中华创伤骨科杂志, 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. 黄国秀, 谭海涛. 3D打印模型在椎间孔镜手术教学中的应用进展. 中国医学教育技术, 2017, 31(4): 460-464.

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