Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey

Study Design Expanding upon established surgical simulation methods, we developed a fused deposition modeling three-dimensional (3D)-printed model of the C1–T1 vertebra for posterior cervical foraminotomy training that features silicone-based neural elements, polyurethane foam-based ligaments, and p...

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Main Authors: Bilal Bahadır Akbulut, Elif Ezgi Çenberlitaş, Mustafa Serdar Bölük, Taşkın Yurtseven, Hüseyin Biçeroğlu
Format: Article
Language:English
Published: Korean Spine Society 2025-04-01
Series:Asian Spine Journal
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Online Access:http://asianspinejournal.org/upload/pdf/asj-2025-0050.pdf
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author Bilal Bahadır Akbulut
Elif Ezgi Çenberlitaş
Mustafa Serdar Bölük
Taşkın Yurtseven
Hüseyin Biçeroğlu
author_facet Bilal Bahadır Akbulut
Elif Ezgi Çenberlitaş
Mustafa Serdar Bölük
Taşkın Yurtseven
Hüseyin Biçeroğlu
author_sort Bilal Bahadır Akbulut
collection DOAJ
description Study Design Expanding upon established surgical simulation methods, we developed a fused deposition modeling three-dimensional (3D)-printed model of the C1–T1 vertebra for posterior cervical foraminotomy training that features silicone-based neural elements, polyurethane foam-based ligaments, and polyethylene terephthalate glycol vertebrae. Purpose This study evaluated the effectiveness of a cost-efficient 3D-printed training model designed to help neurosurgical residents acquire fundamental skills in endoscopic posterior cervical foraminotomy while addressing the technique’s challenging learning curve and limited training resources. Overview of Literature Only a few studies have investigated the efficacy of such a model. Methods Eight neurosurgery residents each with over 2 years of training completed four training sessions on two randomly assigned cervical spine levels using the newly developed 3D-printed model. A simple plumbing endoscope was used for real-time surgical visualization. Results Among the 64 completed surgical levels, left-sided procedures showed significantly higher insufficient decompression rates than did right-sided procedures (25.0% vs. 3.6%, p=0.002). However, no significant difference in overall complication rates was observed between sides (p=0.073). Surgical parameters remained consistent across sides, with no significant differences in operative duration. Brunner-Langer analysis revealed substantial improvements in operative duration (mean duration decrease from 21:42±2:15 to 6:33±0:42 minutes, p=0.004) and total complications (mean decrease from 2.1±0.8 to 0.4±0.5, p=0.007) across sessions. Although fluoroscopy timing showed marginal improvement (mean duration decrease from 2:12±1:15 to 0:55±0:23 minutes, p=0.057), the number of fluoroscopic images tended to decrease. Conclusions Our findings suggest that this novel 3D-printed cervical spine model could be a viable, low-cost option for neurosurgical training programs aiming to help residents develop essential endoscopic skills in a controlled setting. Facilitating early proficiency in posterior cervical foraminotomy can serve as a valuable intermediate step before transitioning to cadaveric models and clinical practice.
format Article
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institution Kabale University
issn 1976-1902
1976-7846
language English
publishDate 2025-04-01
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record_format Article
series Asian Spine Journal
spelling doaj-art-7249417b330d43d78a8d9edc8ad6dce22025-08-20T03:54:01ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462025-04-0119218319310.31616/asj.2025.00501739Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from TurkeyBilal Bahadır Akbulut0Elif Ezgi Çenberlitaş1Mustafa Serdar Bölük2Taşkın Yurtseven3Hüseyin Biçeroğlu4 Department of Neurosurgery, Ege University, Izmir, Turkey Department of Neurosurgery, Ege University, Izmir, Turkey Department of Neurosurgery, Ege University, Izmir, Turkey Department of Neurosurgery, Ege University, Izmir, Turkey Department of Neurosurgery, Ege University, Izmir, TurkeyStudy Design Expanding upon established surgical simulation methods, we developed a fused deposition modeling three-dimensional (3D)-printed model of the C1–T1 vertebra for posterior cervical foraminotomy training that features silicone-based neural elements, polyurethane foam-based ligaments, and polyethylene terephthalate glycol vertebrae. Purpose This study evaluated the effectiveness of a cost-efficient 3D-printed training model designed to help neurosurgical residents acquire fundamental skills in endoscopic posterior cervical foraminotomy while addressing the technique’s challenging learning curve and limited training resources. Overview of Literature Only a few studies have investigated the efficacy of such a model. Methods Eight neurosurgery residents each with over 2 years of training completed four training sessions on two randomly assigned cervical spine levels using the newly developed 3D-printed model. A simple plumbing endoscope was used for real-time surgical visualization. Results Among the 64 completed surgical levels, left-sided procedures showed significantly higher insufficient decompression rates than did right-sided procedures (25.0% vs. 3.6%, p=0.002). However, no significant difference in overall complication rates was observed between sides (p=0.073). Surgical parameters remained consistent across sides, with no significant differences in operative duration. Brunner-Langer analysis revealed substantial improvements in operative duration (mean duration decrease from 21:42±2:15 to 6:33±0:42 minutes, p=0.004) and total complications (mean decrease from 2.1±0.8 to 0.4±0.5, p=0.007) across sessions. Although fluoroscopy timing showed marginal improvement (mean duration decrease from 2:12±1:15 to 0:55±0:23 minutes, p=0.057), the number of fluoroscopic images tended to decrease. Conclusions Our findings suggest that this novel 3D-printed cervical spine model could be a viable, low-cost option for neurosurgical training programs aiming to help residents develop essential endoscopic skills in a controlled setting. Facilitating early proficiency in posterior cervical foraminotomy can serve as a valuable intermediate step before transitioning to cadaveric models and clinical practice.http://asianspinejournal.org/upload/pdf/asj-2025-0050.pdfendoscopesresidencyminimally invasive surgical proceduresthree-dimensional printingsimulation training
spellingShingle Bilal Bahadır Akbulut
Elif Ezgi Çenberlitaş
Mustafa Serdar Bölük
Taşkın Yurtseven
Hüseyin Biçeroğlu
Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey
Asian Spine Journal
endoscopes
residency
minimally invasive surgical procedures
three-dimensional printing
simulation training
title Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey
title_full Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey
title_fullStr Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey
title_full_unstemmed Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey
title_short Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey
title_sort development and validation of a cost effective three dimensional printed cervical spine model for endoscopic posterior cervical foraminotomy training a prospective educational study from turkey
topic endoscopes
residency
minimally invasive surgical procedures
three-dimensional printing
simulation training
url http://asianspinejournal.org/upload/pdf/asj-2025-0050.pdf
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