A group of researchers from the梅奥诊所, the佐治亚理工学院，和Medical University of South Carolinahave 3D printed a low-cost proof-of-concept spinal surgical simulator.
The aim of the study is to raise awareness of the lack of current surgical training alternatives to traditional methods that can be inconvenient, inaccessible, and incompatible with intraoperative neuromonitoring (IONM) systems.
该团队提供了低成本的替代方案，创建了横向访问训练模型（LATM），该模型具有3D打印的腰椎椎骨，以验证了解剖学精度。
Improving spinal surgery with 3D printing
Additive manufacturing has found its place in the medical sector, particularly in regard to improving surgical training and outcomes. Spinal surgery is no different, with the technology promising to提高脊柱手术的成功率和治疗。
就治疗而言，研究人员University of Minnesota开发了一个原型带有活细胞的3D打印脚手架这可能会恢复脊髓损伤患者的某些功能，而来自加州大学圣地亚哥分校successfully3D打印了两毫米脊髓植入物修复大鼠的脊髓损伤。最近，再生医学公司矩阵successfully tested a first-of-its-kind3D打印的脊髓组织植入物这使瘫痪的老鼠再次行走。
Regarding improving surgical training and outcomes, orthopedic implant firm4WEB医疗独立3D printed Anterior Spin Truss System在脊柱程序中为外科医生提供更大的信心，以及3D打印的骨科开发人员Orthofix Medicalhas developed itsforza ti plif垫片系统设计用于后腰椎室内融合手术。
3D打印的LATM
Minimally invasive lateral lumbar interbody fusion (LLIF) is a relatively recent development in spinal surgery, providing minimally invasive access for indirect nerve decompression and the correction of lumbar degenerative deformities while avoiding the challenges and risks of traditional approaches. However, the technique requires a specialized team and advanced equipment, and current training tends to be limited to classic educational models and cadaver labs, which can be inconvenient, inaccessible, and expensive.
To highlight the lack of current training alternatives, the team’s study aimed to create a fully synthetic and low-cost proof-of-concept lateral lumbar surgical simulator. Before fabricating the model, the team interviewed a selection of neurosurgeons, engineers, nurses, and industry partners with a thorough understanding of the LLIF procedure to provide critical input on the visual, tactile, and auditory feedback required for the model.
LATM由躯干外壳，脊柱模块和离子功能组成，并具有可操作的ABS 3D印刷腰椎。椎骨的解剖精度和与荧光镜检查的兼容性进行了验证，荧光镜检查是一种医疗程序，可以实时视频体内运动内部的一部分。研究人员说，使用3D打印ABS的优点是它在脊柱仪器方面的性能很好。
此外，LATM可确保单个3D打印的椎骨和骨盆，并带有柔性聚合物管内的脊柱管中。胸腔囊和神经组织位于椎管内，这意味着在该区域具有支撑结构不会干扰模型的可操作性，因为在LLIF期间绝不应违反脊柱管。
该模型与一种新型的神经监测模拟算法协同起作用，该算法是为了培训初级外科医生的神经系统并发症。根据该团队的说法，3D打印手术模拟器可能有可能减少LLIF手术的学习曲线，实现预性练习，并最终改善患者的预后。
在设计过程开始时接受采访的专家提供了有关LATM的一致积极反馈，标志着模拟器是提供可靠且廉价的基本基本腰椎脊柱训练的第一步。尽管它缺乏一些解剖学特征，但该模拟器为外侧腰部手术方法提供了新颖的训练机会，同时还为可以建立未来模型的基础奠定了基础。
The team said future iterations could impact the future of individualized medicine by providing inexpensive, realistic, and customizable models, and subsequently lead to increased patient safety and improved surgical outcomes.
有关该研究的更多信息可以在标题为：“创建概念验证3D打印的脊柱横向访问模拟器，”发表在《肉质杂志》上。该研究由M. Pullen，F。Valero-Moreno，S。Rajendran，V。Shah，B。Bruneau，J。Martinez，A。Ramos-Fresnedo，A。Quinones-Hinojosa和W. Fox合着。
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特色图片显示CAD渲染（左）和概念证明LATM手术模拟器（右）。通过肉质图像。
