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Sufianov A, Ovalle CS, Cruz O, Contreras J, Begagić E, Kannan S, Rosario Rosario A, Chmutin G, Askatovna GN, Lafuente J, Sanchez JS, Nurmukhametov R, Soto García ME, Peev N, Pojskić M, Reyes-Soto G, Bozkurt I, Encarnación Ramírez MDJ. Low-Cost 3D Models for Cervical Spine Tumor Removal Training for Neurosurgery Residents. Brain Sci 2024; 14:547. [PMID: 38928547 PMCID: PMC11201732 DOI: 10.3390/brainsci14060547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 05/19/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Spinal surgery, particularly for cervical pathologies such as myelopathy and radiculopathy, requires a blend of theoretical knowledge and practical skill. The complexity of these conditions, often necessitating surgical intervention, underscores the need for intricate understanding and precision in execution. Advancements in neurosurgical training, especially with the use of low-cost 3D models for simulating cervical spine tumor removal, are revolutionizing this field. These models provide the realistic and hands-on experience crucial for mastering complex neurosurgical techniques, filling gaps left by traditional educational methods. MATERIALS AND METHODS This study aimed to assess the effectiveness of 3D-printed cervical vertebrae models in enhancing surgical skills, focusing on tumor removal, and involving 20 young neurosurgery residents. These models, featuring silicone materials to simulate the spinal cord and tumor tissues, provided a realistic training experience. The training protocol included a laminectomy, dural incision, and tumor resection, using a range of microsurgical tools, focusing on steps usually performed by senior surgeons. RESULTS The training program received high satisfaction rates, with 85% of participants extremely satisfied and 15% satisfied. The 3D models were deemed very realistic by 85% of participants, effectively replicating real-life scenarios. A total of 80% found that the simulated pathologies were varied and accurate, and 90% appreciated the models' accurate tactile feedback. The training was extremely useful for 85% of the participants in developing surgical skills, with significant post-training confidence boosts and a strong willingness to recommend the program to peers. CONCLUSIONS Continuing laboratory training for residents is crucial. Our model offers essential, accessible training for all hospitals, regardless of their resources, promising improved surgical quality and patient outcomes across various pathologies.
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Affiliation(s)
- Albert Sufianov
- Federal State Budgetary Institution the Federal Center of Neurosurgery of the Ministry of Health of the Russian Federation, 625062 Tyumen, Russia
- Department of Neurosurgery, State Medical University (Sechenov University), 119991 Moscow, Russia
- Educational and Scientific Institute of Neurosurgery, Peoples’ Friendship University of Russia RUDN University, 117198 Moscow, Russia
| | - Carlos Salvador Ovalle
- Department of Neurosurgery, National University of Mexico Hospital General, Durango 34030, Mexico
| | - Omar Cruz
- Department of Neurosurgery, National University of Mexico Hospital General, Durango 34030, Mexico
| | - Javier Contreras
- Department of Neurosurgery, National University of Mexico Hospital General, Durango 34030, Mexico
| | - Emir Begagić
- Department of General Medicine, School of Medicine, University of Zenica, 72000 Zenica, Bosnia and Herzegovina
| | - Siddarth Kannan
- School of Medicine, University of Central Lancashire, Preston PR02AG, UK
| | | | - Gennady Chmutin
- Petrovsky Russian Scientific Center of Surgery, 121359 Moscow, Russia
| | - Garifullina Nargiza Askatovna
- Federal State Budgetary Institution the Federal Center of Neurosurgery of the Ministry of Health of the Russian Federation, 625062 Tyumen, Russia
| | - Jesus Lafuente
- Spine Center Hospital del Mar, Sagrat Cor University Hospital, 08029 Barcelona, Spain
| | - Jose Soriano Sanchez
- Instituto Soriano de Cirugía de Columna Mínimamente Invasiva at ABC Hospital, Neurological Center, Santa Fe Campus, Mexico City 05100, Mexico
| | - Renat Nurmukhametov
- NCC No. 2 Federal State Budgetary Scientific Institution Russian Scientific Center Named after. Acad. B.V. Petrovsky (Central Clinical Hospital Russian Academy of Sciences), 121359 Moscow, Russia
| | | | - Nikolay Peev
- Department of Neurosurgery, Russian People’s Friendship University, 117198 Moscow, Russia
| | - Mirza Pojskić
- Department of Neurosurgery, University Hospital Marburg, Baldingerstr., 35033 Marburg, Germany
| | - Gervith Reyes-Soto
- Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Ismail Bozkurt
- Department of Neurosurgery, Medical Park Ankara Hospital, Kent Koop Mah 1868. Sok, Batıkent Blv. No:15, 06680 Ankara, Turkey
- Department of Neurosurgery, School of Medicine, Yuksek Ihtisas University, 06520 Ankara, Turkey
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Chytas D, Piagkou M, Tsakotos G, Protogerou V, Demesticha T, Natsis K. Methods and outcomes of teaching functional anatomy of the musculoskeletal system: A scoping review. Morphologie 2024; 108:100729. [PMID: 38007970 DOI: 10.1016/j.morpho.2023.100729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE Although musculoskeletal anatomy is inherently related to motion, there is a lack of evidence review about the best teaching practices for the locomotor apparatus functional anatomy. We aimed to detect the strategies that have been implemented for functional musculoskeletal anatomy education, and their outcomes, with the ultimate purpose of suggesting the most effective teaching methods. METHODS The databases PubMed, Scopus, ERIC, and Cochrane Library were searched for papers with the purpose of exploring the outcomes (participants' perceptions and/or examination performance) of teaching functional musculoskeletal anatomy. From each study, the following information was extracted: author(s), number of participants, implementation method, participants' perceptions and/or examination performance after the educational intervention, and classification of the outcomes according to the Kirkpatrick hierarchy. RESULTS Seven papers were included. Six of them involved active learning strategies (other than seeing, listening, and taking notes). Several specific teaching methods were implemented, including physical activities, lectures, textbooks, atlases, prosected specimens, near-peer teaching, and digital and physical models. Overall, methods that involved active learning, especially some form of physical activity, had the best educational outcomes, while passive learning was not found to be significantly more effective in any case. The role of modern anatomy education technologies has been inadequately explored. CONCLUSIONS It appears that teaching functional musculoskeletal anatomy is more successful when using active learning methods, especially involving some form of physical activity. More research is necessary to determine the best environment for these methods and investigate the role of modern technologies in functional musculoskeletal anatomy education.
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Affiliation(s)
- D Chytas
- Basic Sciences Laboratory, Department of Physiotherapy, University of Peloponnese, 20, Plateon street, 23100, Sparta, Greece; European University of Cyprus, 6, Diogenous street, 2404 Engomi, Nicosia, Cyprus.
| | - M Piagkou
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75, Mikras Asias street, 11527 Athens, Greece
| | - G Tsakotos
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75, Mikras Asias street, 11527 Athens, Greece
| | - V Protogerou
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75, Mikras Asias street, 11527 Athens, Greece
| | - T Demesticha
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75, Mikras Asias street, 11527 Athens, Greece
| | - K Natsis
- Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Lin M, Paul R, Liao X, Doulgeris J, Menzer EL, Dhar UK, Tsai CT, Vrionis FD. A New Method to Evaluate Pressure Distribution Using a 3D-Printed C2-C3 Cervical Spine Model with an Embedded Sensor Array. SENSORS (BASEL, SWITZERLAND) 2023; 23:9547. [PMID: 38067922 PMCID: PMC10708625 DOI: 10.3390/s23239547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023]
Abstract
Cervical degenerative disc diseases such as myelopathy and radiculopathy often require conventional treatments like artificial cervical disc replacement or anterior cervical discectomy and fusion (ACDF). When designing a medical device, like the stand-alone cage, there are many design inputs to consider. However, the precise biomechanics of the force between the vertebrae and implanted devices under certain conditions require further investigation. In this study, a new method was developed to evaluate the pressure between the vertebrae and implanted devices by embedding a sensor array into a 3D-printed C2-C3 cervical spine. The 3D-printed cervical spine model was subjected to a range of axial loads while under flexion, extension, bending and compression conditions. Cables were used for the application of a preload and a robotic arm was used to recreate the natural spine motions (flexion, extension, and bending). To verify and predict the total pressure between the vertebrae and the implanted devices, a 3D finite element (FE) numerical mathematical model was developed. A preload was represented by applying 22 N of force on each of the anterior tubercles for the C2 vertebra. The results of this study suggest that the sensor is useful in identifying static pressure. The pressure with the robot arm was verified from the FE results under all conditions. This study indicates that the sensor array has promising potential to reduce the trial and error with implants for various surgical procedures, including multi-level artificial cervical disk replacement and ACDF, which may help clinicians to reduce pain, suffering, and costly follow-up procedures.
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Affiliation(s)
- Maohua Lin
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA; (M.L.); (R.P.); (U.K.D.); (C.-T.T.)
| | - Rudy Paul
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA; (M.L.); (R.P.); (U.K.D.); (C.-T.T.)
| | - Xinqin Liao
- Department of Electronic Science, Xiamen University, Xiamen 361005, China;
| | - James Doulgeris
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA; (M.L.); (R.P.); (U.K.D.); (C.-T.T.)
| | - Emma Lilly Menzer
- Department of Biological Sciences, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Utpal Kanti Dhar
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA; (M.L.); (R.P.); (U.K.D.); (C.-T.T.)
| | - Chi-Tay Tsai
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA; (M.L.); (R.P.); (U.K.D.); (C.-T.T.)
| | - Frank D. Vrionis
- Department of Neurosurgery, Marcus Neuroscience Institute, Boca Raton Regional Hospital, Boca Raton, FL 33486, USA
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Chytas D, Paraskevas G, Demesticha T, Asouhidou I, Troupis T. Considerations for the Value of Dynamic Virtual Models for Clinical Musculoskeletal Anatomy Education. MEDICAL SCIENCE EDUCATOR 2023; 33:1285-1286. [PMID: 37886293 PMCID: PMC10597953 DOI: 10.1007/s40670-023-01845-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 10/28/2023]
Affiliation(s)
- Dimitrios Chytas
- Basic Sciences Laboratory, Department of Physiotherapy, University of Peloponnese, 20, Plateon Str., 23100 Sparta, Greece
- European University of Cyprus, 6, Diogenous Str., 2404 Nicosia, Engomi Cyprus
| | - Georgios Paraskevas
- Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Theano Demesticha
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75, Mikras Asias Str., 11527 Athens, Greece
| | - Irene Asouhidou
- Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Theodore Troupis
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75, Mikras Asias Str., 11527 Athens, Greece
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Patel SJ, Notarianni AP, Martin AK, Tsai A, Pulton DA, Linganna R, Patel PA, Waldron NH, Nimma SR, Bodmer NJ, Kothari P, Jackson E, Gupta RG, Roberts ML, Feinman JW. The Year in Graduate Medical Education: Selected Highlights From 2022. J Cardiothorac Vasc Anesth 2023:S1053-0770(23)00275-6. [PMID: 37210326 DOI: 10.1053/j.jvca.2023.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/22/2023]
Affiliation(s)
- Saumil J Patel
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Philadelphia, PA
| | - Andrew P Notarianni
- Department of Anesthesiology, Cardiothoracic Division, Yale University School of Medicine, New Haven, CT
| | - Archer Kilbourne Martin
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Albert Tsai
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Danielle A Pulton
- Department of Anesthesiology, Temple University Hospital/Lewis Katz School of Medicine, Philadelphia, PA
| | - Regina Linganna
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Philadelphia, PA
| | - Prakash A Patel
- Department of Anesthesiology, Cardiothoracic Division, Yale University School of Medicine, New Haven, CT
| | - Nathan H Waldron
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Sindhuja R Nimma
- Division of Regional Anesthesiology and Acute Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Natalie J Bodmer
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Perin Kothari
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Ethan Jackson
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Ragini G Gupta
- Department of Anesthesiology, Temple University Hospital/Lewis Katz School of Medicine, Philadelphia, PA
| | - Monique L Roberts
- Department of Anesthesiology, Temple University Hospital/Lewis Katz School of Medicine, Philadelphia, PA
| | - Jared W Feinman
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Philadelphia, PA.
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Properties and Implementation of 3-Dimensionally Printed Models in Spine Surgery: A Mixed-Methods Review With Meta-Analysis. World Neurosurg 2023; 169:57-72. [PMID: 36309334 DOI: 10.1016/j.wneu.2022.10.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Spine surgery addresses a wide range of spinal pathologies. Potential applications of 3-dimensional (3D) printed in spine surgery are broad, encompassing education, planning, and simulation. The objective of this study was to explore how 3D-printed spine models are implemented in spine surgery and their clinical applications. METHODS Methods were combined to create a scoping review with meta-analyses. PubMed, EMBASE, the Cochrane Library, and Scopus databases were searched from 2011 to 7 September 2021. Results were screened independently by 2 reviewers. Studies utilizing 3D-printed spine models in spine surgery were included. Articles describing drill guides, implants, or nonoriginal research were excluded. Data were extracted according to reporting guidelines in relation to study information, use of model, 3D printer and printing material, design features of the model, and clinical use/patient-related outcomes. Meta-analyses were performed using random-effects models. RESULTS Forty articles were included in the review, 3 of which were included in the meta-analysis. Primary use of the spine models included preoperative planning, education, and simulation. Six printing technologies were utilized. A range of substrates were used to recreate the spine and regional pathology. Models used for preoperative and intraoperative planning showed reductions in key surgical performance indicators. Generally, feedback for the tactility, utility, and education use of models was favorable. CONCLUSIONS Replicating realistic spine models for operative planning, education, and training is invaluable in a subspeciality where mistakes can have devastating repercussions. Future study should evaluate the cost-effectiveness and the impact spine models have of spine surgery outcomes.
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Kabra A, Mehta N, Garg B. 3D printing in spine care: A review of current applications. J Clin Orthop Trauma 2022; 35:102044. [PMID: 36340962 PMCID: PMC9633990 DOI: 10.1016/j.jcot.2022.102044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/10/2022] [Accepted: 10/18/2022] [Indexed: 12/14/2022] Open
Abstract
3D printing (3DP) has been brought to medical use since the early part of this century- but it has been widely researched on and publicized only in the last few years. Amongst patients with spinal disorders, 3DP has been utilized in various facets of patient care. These include pre-operative aspects - such as patient education, resident training, pre-operative planning and simulations, intra-operative assistance in the form of customized jigs for pedicle screw insertion, patient specific interbody cages and vertebral body substitutes in complex malignancies and spinal infections. It has also been utilized in deformity surgeries and has opened new avenues in minimally invasive spine care. Guidelines have now been drafted by various organizations including the FDA with a prime focus on quality control measures applicable to this new technology. There has been a recent surge in publications supporting the use of 3DP in spinal disorders, reporting an improvement in various aspects of patient care. As the technology spreads out its wings further, more innovations and applications are expected to unfold in the coming years. Considering the rapid advances that 3DP has made, having a basic understanding of this technology is imperative for all spine surgeons. Despite promising preliminary results, there still exist a few pitfalls of the technology which have hindered the universal application of 3DP. Most importantly, there is a dearth of data related to long term outcomes supporting its clinical use. The prohibitive cost of 3D models, the specialized manpower it necessitates and the need for specific instrumentation are major deterrents to widespread use of this technology, particularly in small-scale healthcare setups. With further advancements in technology, the goal must be to make it more accurate and affordable to hospitals and patients so that the benefits of the technology can reach a wider patient population.
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Affiliation(s)
- Apoorva Kabra
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Nishank Mehta
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Bhavuk Garg
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
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Virtual Scoliosis Surgery Using a 3D-Printed Model Based on Biplanar Radiographs. Bioengineering (Basel) 2022; 9:bioengineering9090469. [PMID: 36135015 PMCID: PMC9495694 DOI: 10.3390/bioengineering9090469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this paper is to describe a protocol that simulates the spinal surgery undergone by adolescents with idiopathic scoliosis (AIS) by using a 3D-printed spine model. Patients with AIS underwent pre- and postoperative bi-planar low-dose X-rays from which a numerical 3D model of their spine was generated. The preoperative numerical spine model was subsequently 3D printed to virtually reproduce the spine surgery. Special consideration was given to the printing materials for the 3D-printed elements in order to reflect the radiopaque and mechanical properties of typical bones most accurately. Two patients with AIS were recruited and operated. During the virtual surgery, both pre- and postoperative images of the 3D-printed spine model were acquired. The proposed 3D-printing workflow used to create a realistic 3D-printed spine suitable for virtual surgery appears to be feasible and reliable. This method could be used for virtual-reality scoliosis surgery training incorporating 3D-printed models, and to test surgical instruments and implants.
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Park CK. 3D-Printed Disease Models for Neurosurgical Planning, Simulation, and Training. J Korean Neurosurg Soc 2022; 65:489-498. [PMID: 35762226 PMCID: PMC9271812 DOI: 10.3340/jkns.2021.0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/17/2021] [Indexed: 11/27/2022] Open
Abstract
Spatial insight into intracranial pathology and structure is important for neurosurgeons to perform safe and successful surgeries. Three-dimensional (3D) printing technology in the medical field has made it possible to produce intuitive models that can help with spatial perception. Recent advances in 3D-printed disease models have removed barriers to entering the clinical field and medical market, such as precision and texture reality, speed of production, and cost. The 3D-printed disease model is now ready to be actively applied to daily clinical practice in neurosurgical planning, simulation, and training. In this review, the development of 3D-printed neurosurgical disease models and their application are summarized and discussed.
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Affiliation(s)
- Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Shi J, Cavagnaro MJ, Xu S, Zhao M. The Application of Three-Dimensional Technologies in the Improvement of Orthopedic Surgery Training and Medical Education Quality: A Comparative Bibliometrics Analysis. Front Bioeng Biotechnol 2022; 10:852608. [PMID: 35392408 PMCID: PMC8980319 DOI: 10.3389/fbioe.2022.852608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Orthopedics is a medical specialty that focuses on the clinical treatment and care of the musculoskeletal system. Orthopedics is a medical specialty which specializing in the clinical treatment and nursing of musculoskeletal system. The education of orthopedics is often serious and difficult because of the high technical requirements, complicated anatomical knowledge and long study process. However, medical students or junior residents rarely have the opportunity to see such orthopedic surgery or attend preclinical practice, which limits the opportunities for training clinicians. Hopefully, with the increasing use of three-dimensional (3D) technologies in medical teaching, this situation can be alleviated. In this study, we demonstrate that different 3D technologies can effectively simulate orthopedic surgery with very high accuracy. We carefully evaluated the use of 3D technologies in primary medical teaching and proposed a vision for the future. We searched and screened 3,997 publications from the Web of Science Core Collection (WoSCC) on 22 Oct 2021 with (trauma) AND ((education) OR (training) OR (teaching) OR (learning)) AND ((3D) OR (Three Dimensional)), (Joint) AND ((education) OR (training) OR (teaching) OR (learning)) AND ((3D) OR (Three Dimensional)), (spine) AND ((education) OR (training) OR (teaching) OR (learning)) AND ((3D) OR (Three Dimensional)) as the search strategy. Then, we eliminated the publications irrelevant to “orthopedics” AND/OR “orthopaedic” (in United Kingdom English), the final number of publications are 440 for trauma surgery, 716 for joint surgery and 363 for spine surgery, a visual display of comprehensive information analysis was made by VOSviewer. Next, we read and analyzed retrieved articles extensively according to the selection criteria, 11 highly cited publications on three major branches of orthopedics were chosen. The extracted data included the authors, purpose, methods, results and benefits/limitations. The evaluation of these studies directly and objectively proved the superiority of 3D technologies in orthopedics. Furthermore, the material usage and strength of 3D technologies can be closer to the real situation, which will help improve their effectiveness in teaching. We hope that more relevant studies will be conducted to continue examining the effects of 3D technologies on orthopedic medical education as well as orthopedic surgery training, and we hope that this technique can be more widely used in the clinical teaching of orthopedics to train clinicians on learning medical theory and surgical technology quickly and efficiently.
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Affiliation(s)
- Jian Shi
- Department of Spine Surgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | - María José Cavagnaro
- College of Medicine-Phoenix, The University of Arizona, Phoenix, AZ, United States
| | - Shaokang Xu
- Xiangya School of Medicine, Central South University, Changsha, China
- Department of Pediatric, The Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Shaokang Xu, ; Mingyi Zhao,
| | - Mingyi Zhao
- Department of Pediatric, The Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Shaokang Xu, ; Mingyi Zhao,
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Coupling of Fused Deposition Modeling and Inkjet Printing to Produce Drug Loaded 3D Printed Tablets. Pharmaceutics 2022; 14:pharmaceutics14010159. [PMID: 35057054 PMCID: PMC8781861 DOI: 10.3390/pharmaceutics14010159] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/01/2022] [Accepted: 01/05/2022] [Indexed: 01/30/2023] Open
Abstract
In the current study, we have coupled Fused Deposition Modelling (FDM) for the fabrication of plain polyvinyl alcohol (PVA) tablets followed by dispensing of minoxidil ethanolic solutions using inkjet printing. The use of a drop-on-solid printing approach facilitates an accurate and reproducible process while it controls the deposition of the drug amounts. For the purpose of the study, the effect of the solvent was investigated and minoxidil ink solutions of ethanol 70% v/v (P70) or absolute ethanol (P100) were applied on the plain PVA tablets. Physicochemical characterization showed that solvent miscibility with the polymer substrate plays a key role and can lead to the formation of drug crystals on the surface or drug absorption in the polymer matrix. The produced minoxidil tablets showed sustained release profiles or initial bursts strongly affected by the solvent grade used for dispensing the required dose on drug loaded 3D printed tablets. This paradigm demonstrates that the coupling of FDM and inkjet printing technologies could be used for rapid development of personalized dosage forms.
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Lin M, Abd MA, Taing A, Tsai CT, Vrionis FD, Engeberg ED. Robotic Replica of a Human Spine Uses Soft Magnetic Sensor Array to Forecast Intervertebral Loads and Posture after Surgery. SENSORS (BASEL, SWITZERLAND) 2021; 22:s22010212. [PMID: 35009754 PMCID: PMC8749580 DOI: 10.3390/s22010212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 05/07/2023]
Abstract
Cervical disc implants are conventional surgical treatments for patients with degenerative disc disease, such as cervical myelopathy and radiculopathy. However, the surgeon still must determine the candidacy of cervical disc implants mainly from the findings of diagnostic imaging studies, which can sometimes lead to complications and implant failure. To help address these problems, a new approach was developed to enable surgeons to preview the post-operative effects of an artificial disc implant in a patient-specific fashion prior to surgery. To that end, a robotic replica of a person's spine was 3D printed, modified to include an artificial disc implant, and outfitted with a soft magnetic sensor array. The aims of this study are threefold: first, to evaluate the potential of a soft magnetic sensor array to detect the location and amplitude of applied loads; second, to use the soft magnetic sensor array in a 3D printed human spine replica to distinguish between five different robotically actuated postures; and third, to compare the efficacy of four different machine learning algorithms to classify the loads, amplitudes, and postures obtained from the first and second aims. Benchtop experiments showed that the soft magnetic sensor array was capable of precisely detecting the location and amplitude of forces, which were successfully classified by four different machine learning algorithms that were compared for their capabilities: Support Vector Machine (SVM), K-Nearest Neighbor (KNN), Random Forest (RF), and Artificial Neural Network (ANN). In particular, the RF and ANN algorithms were able to classify locations of loads applied 3.25 mm apart with 98.39% ± 1.50% and 98.05% ± 1.56% accuracies, respectively. Furthermore, the ANN had an accuracy of 94.46% ± 2.84% to classify the location that a 10 g load was applied. The artificial disc-implanted spine replica was subjected to flexion and extension by a robotic arm. Five different postures of the spine were successfully classified with 100% ± 0.0% accuracy with the ANN using the soft magnetic sensor array. All results indicated that the magnetic sensor array has promising potential to generate data prior to invasive surgeries that could be utilized to preoperatively assess the suitability of a particular intervention for specific patients and to potentially assist the postoperative care of people with cervical disc implants.
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Affiliation(s)
- Maohua Lin
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA; (M.L.); (M.A.A.); (C.-T.T.)
| | - Moaed A. Abd
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA; (M.L.); (M.A.A.); (C.-T.T.)
| | - Alex Taing
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22904, USA;
| | - Chi-Tay Tsai
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA; (M.L.); (M.A.A.); (C.-T.T.)
| | - Frank D. Vrionis
- Department of Neurosurgery, Marcus Neuroscience Institute, Boca Raton Regional Hospital, Boca Raton, FL 33486, USA
- Correspondence: (F.D.V.); (E.D.E.)
| | - Erik D. Engeberg
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA; (M.L.); (M.A.A.); (C.-T.T.)
- Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL 33431, USA
- Correspondence: (F.D.V.); (E.D.E.)
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13
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Ovsepyan AL, Smirnov AA, Pustozerov EA, Mokhov DE, Mokhova ES, Trunin EM, Dydykin SS, Vasil'ev YL, Yakovlev EV, Budday S, Paulsen F, Zhivolupov SA, Starchik DA. Biomechanical analysis of the cervical spine segment as a method for studying the functional and dynamic anatomy of the human neck. Ann Anat 2021; 240:151856. [PMID: 34793958 DOI: 10.1016/j.aanat.2021.151856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/11/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Traditionally, dynamic and functional anatomy, in particular the dynamic anatomy of the neck, is studied on cadaveric material. However, the development of in vivo visualization technologies and in silico modeling has made it possible to expand these possibilities. Despite significant progress in the study of dynamic and functional anatomy of the neck by means of in silico methods, the issues of validating the developed models and taking into account the pronounced nonlinearity of soft tissues as well as local anisotropy remain open. The aim of this study was to develop a virtual dynamic anatomical model of the human neck and reproduce the dynamic processes in the cervical spine from this model using the finite element method. MATERIALS AND METHODS Reverse engineering was used to generate a dynamic anatomical model of the neck from CT data (both male, 24 and 22 years old). Two segments of the cervical spine (C3-C5, C2-T1) were isolated from the resulting model for finite element analysis. Finite element mesh generation and contact interactions were performed using the HyperMesh software (Altair Engineering Inc, Troy, Michigan, USA). The anisotropic hyperelastic Holzapfel-Gasser-Ogden model was used to describe the material behavior of the fibrous rings of the disc. Material modeling and finite element analysis were performed using Abaqus CAE 6.14 software (Simulia, Johnston, Rhode Island, USA). RESULTS A technique for creating a virtual dynamic anatomical model of the neck was elaborated and implemented. The model includes 79 major anatomical structures of the neck segmented from radiological data. A finite element analysis of the cervical spine was performed. The results of finite element analysis of the C3-C5 segment under axial load were compared with in vitro data. The proposed model shows nonlinear deformation of the disc under static loading; the model predicted displacement values agree well with the experimental ones. The displacement of the С3-С5 central vertebra with an axial load of 800 N reaches a value of 0.65 mm. For the segment C2-T1, data on intradiscal pressure, stress plots and displacements during flexion were obtained. The maximum stress value of 10.036 MPa is observed in the C3-C4 disc. CONCLUSION Simulation results using the proposed methodology are in good agreement with experimental data. The generated biomechanical models allow describing dynamic phenomena in the cervical spine and obtaining a wide range of quantitative properties of anatomical objects, which are otherwise inaccessible to classical methods for studying dynamic and functional anatomy.
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Affiliation(s)
- A L Ovsepyan
- Saint Petersburg Electrotechnical University "LETI", Department of Bioengineering Systems, St. Petersburg, Russia
| | - A A Smirnov
- Moscow Region State University, Moscow, Russia.
| | - E A Pustozerov
- Saint Petersburg Electrotechnical University "LETI", Department of Bioengineering Systems, St. Petersburg, Russia; Almazov National Medical Research Centre, Institute of Endocrinology, St. Petersburg, Russia
| | - D E Mokhov
- North-Western State Medical University Named After I.I. Mechnikov, Department of Osteopathy, St. Petersburg, Russia
| | - E S Mokhova
- Insitute of the Osteopathy, St. Petersburg State University, Russia
| | - E M Trunin
- North-Western State Medical University Named After I.I. Mechnikov, Department of Operative and Clinical Surgery with Topographical Anatomy Named After S.A. Simbirtsev, St. Petersburg, Russia
| | - S S Dydykin
- Sechenov University, Department of Operative Surgery and Topographic Anatomy, Moscow, Russia
| | - Yu L Vasil'ev
- Sechenov University, Department of Operative Surgery and Topographic Anatomy, Moscow, Russia
| | - E V Yakovlev
- Medical Center of JSC "Admiralteyskie Verfi", St. Petersburg, Russia; Department of Psychophysiology of the Institute of Applied Psychoanalysis and Psychology of the "University at the Interparliamentary Assembly of EurAsEC", St. Petersburg, Russia
| | - S Budday
- Friedrich Alexander University Erlangen-Nürnberg, Department of Mechanical Engineering, Erlangen, Germany
| | - F Paulsen
- Sechenov University, Department of Operative Surgery and Topographic Anatomy, Moscow, Russia; Friedrich Alexander University Erlangen-Nürnberg, Institute of Functional and Clinical Anatomy, Erlangen, Germany
| | - S A Zhivolupov
- Military Medical Academy Named After S.M. Kirov of the Ministry of Defense of the Russian Federation (St. Petersburg), Department of Nervous Diseases, St. Petersburg, Russia
| | - D A Starchik
- North-Western State Medical University Named After I.I. Mechnikov, Department of Morphology, St. Petersburg, Russia
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14
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Senbekov M, Saliev T, Bukeyeva Z, Almabayeva A, Zhanaliyeva M, Aitenova N, Toishibekov Y, Fakhradiyev I. The Recent Progress and Applications of Digital Technologies in Healthcare: A Review. Int J Telemed Appl 2020; 2020:8830200. [PMID: 33343657 PMCID: PMC7732404 DOI: 10.1155/2020/8830200] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The implementation of medical digital technologies can provide better accessibility and flexibility of healthcare for the public. It encompasses the availability of open information on the health, treatment, complications, and recent progress on biomedical research. At present, even in low-income countries, diagnostic and medical services are becoming more accessible and available. However, many issues related to digital health technologies remain unmet, including the reliability, safety, testing, and ethical aspects. PURPOSE The aim of the review is to discuss and analyze the recent progress on the application of big data, artificial intelligence, telemedicine, block-chain platforms, smart devices in healthcare, and medical education. Basic Design. The publication search was carried out using Google Scholar, PubMed, Web of Sciences, Medline, Wiley Online Library, and CrossRef databases. The review highlights the applications of artificial intelligence, "big data," telemedicine and block-chain technologies, and smart devices (internet of things) for solving the real problems in healthcare and medical education. Major Findings. We identified 252 papers related to the digital health area. However, the number of papers discussed in the review was limited to 152 due to the exclusion criteria. The literature search demonstrated that digital health technologies became highly sought due to recent pandemics, including COVID-19. The disastrous dissemination of COVID-19 through all continents triggered the need for fast and effective solutions to localize, manage, and treat the viral infection. In this regard, the use of telemedicine and other e-health technologies might help to lessen the pressure on healthcare systems. Summary. Digital platforms can help optimize diagnosis, consulting, and treatment of patients. However, due to the lack of official regulations and recommendations, the stakeholders, including private and governmental organizations, are facing the problem with adequate validation and approbation of novel digital health technologies. In this regard, proper scientific research is required before a digital product is deployed for the healthcare sector.
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Affiliation(s)
- Maksut Senbekov
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Timur Saliev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | | | - Nazym Aitenova
- NJSC “Astana Medical University”, Nur-Sultan, Kazakhstan
| | | | - Ildar Fakhradiyev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
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