Abstract
BackgroundTraining beginners of the pedicle screw instrumentation technique in the operating room is limited because of issues related to patient safety and surgical efficiency. Three-dimensional (3D) printing enables training or simulation surgery on a real-size replica of deformed spine, which is difficult to perform in the usual cadaver or surrogate plastic models. The purpose of this study was to evaluate the educational effect of using a real-size 3D-printed spine model for training beginners of the free-hand pedicle screw instrumentation technique. We asked whether the use of a 3D spine model can improve (1) screw instrumentation accuracy and (2) length of procedure.MethodsTwenty life-size 3D-printed lumbar spine models were made from 10 volunteers (two models for each volunteer). Two novice surgeons who had no experience of free-hand pedicle screw instrumentation technique were instructed by an experienced surgeon, and each surgeon inserted 10 pedicle screws for each lumbar spine model. Computed tomography scans of the spine models were obtained to evaluate screw instrumentation accuracy. The length of time in completing the procedure was recorded. The results of the latter 10 spine models were compared with those of the former 10 models to evaluate learning effect.ResultsA total of 37/200 screws (18.5%) perforated the pedicle cortex with a mean of 1.7 mm (range, 1.2–3.3 mm). However, the latter half of the models had significantly less violation than the former half (10/100 vs. 27/100, p < 0.001). The mean length of time to complete 10 pedicle screw instrumentations in a spine model was 42.8 ± 5.3 min for the former 10 spine models and 35.6 ± 2.9 min for the latter 10 spine models. The latter 10 spine models had significantly less time than the former 10 models (p < 0.001).ConclusionA life-size 3D-printed spine model can be an excellent tool for training beginners of the free-hand pedicle screw instrumentation.
Highlights
Training beginners of the pedicle screw instrumentation technique in the operating room is limited because of issues related to patient safety and surgical efficiency
Safe and accurate instrumentation of pedicle screws is important, and this technique is one of the major skills that a trainee in spine surgery has to learn and acquire. Training beginners of this technique through surgical procedures of patients in the operating room is limited because of issues related to patient safety and surgical efficiency [13]
The purpose of this study was to evaluate the educational effect of using a life-size 3D-printed spine model for training beginners of the free-hand pedicle screw instrumentation technique in improving screw instrumentation accuracy and procedure time
Summary
Training beginners of the pedicle screw instrumentation technique in the operating room is limited because of issues related to patient safety and surgical efficiency. The purpose of this study was to evaluate the educational effect of using a real-size 3D-printed spine model for training beginners of the free-hand pedicle screw instrumentation technique. Pedicle screws are frequently used in spine surgeries, and their use is expected to increase as the number of spinal fusion surgeries is rapidly increasing [1,2,3,4]. Training beginners of this technique through surgical procedures of patients in the operating room is limited because of issues related to patient safety and surgical efficiency [13].
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