1
|
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.
Collapse
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
| | | |
Collapse
|
2
|
Bliznakova K, Milev M, Dukov N, Atanasova V, Yordanova M, Bliznakov Z. Pilot Study on the Development and Integration of Anthropomorphic Models within the Dental Technician Curriculum. Dent J (Basel) 2024; 12:91. [PMID: 38668003 PMCID: PMC11049345 DOI: 10.3390/dj12040091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/24/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024] Open
Abstract
The effectiveness of modern medical education largely depends on the integration and utilization of digital technologies in teaching various disciplines. In this pilot usability study, we introduced 3D printed anthropomorphic dental models, specifically designed for the elective discipline "Digital and Metal-Free Techniques in Dental Technology" from the curriculum of the Dental Technician specialty in the Medical University of Varna. The evaluation focused on dental technician students' perception of this novel learning environment, its influence on their performance, and the potential for future application of these models and related 3D technologies in their professional practice. A validated satisfaction questionnaire was distributed among 80 students, comprising the total cohort. The results indicated a high acceptance rate, with nearly 95% of participants finding the use of digitally created 3D-printed dental models beneficial. More than 90% believed that exploring digital technologies would enhance their skills. The well-trained instructor's competence in technology use convinced students of its value, with more than 98% expressing a willingness to incorporate these technologies into their future work for improved precision in dental models. However, due to the current high cost of needed equipment, only 10% of participants may practicably introduce this novel technology into their practical work. The use of anatomically accurate 3D printed models is a valuable addition to the current dental technician curriculum in medical colleges.
Collapse
Affiliation(s)
- Kristina Bliznakova
- Faculty of Public Health, Medical University–Varna Prof. Dr. Paraskev Stoyanov, 9002 Varna, Bulgaria; (N.D.); (V.A.); (Z.B.)
| | - Minko Milev
- Medical College, Medical University–Varna Prof. Dr. Paraskev Stoyanov, 9002 Varna, Bulgaria; (M.M.); (M.Y.)
| | - Nikolay Dukov
- Faculty of Public Health, Medical University–Varna Prof. Dr. Paraskev Stoyanov, 9002 Varna, Bulgaria; (N.D.); (V.A.); (Z.B.)
| | - Virginia Atanasova
- Faculty of Public Health, Medical University–Varna Prof. Dr. Paraskev Stoyanov, 9002 Varna, Bulgaria; (N.D.); (V.A.); (Z.B.)
| | - Mariana Yordanova
- Medical College, Medical University–Varna Prof. Dr. Paraskev Stoyanov, 9002 Varna, Bulgaria; (M.M.); (M.Y.)
| | - Zhivko Bliznakov
- Faculty of Public Health, Medical University–Varna Prof. Dr. Paraskev Stoyanov, 9002 Varna, Bulgaria; (N.D.); (V.A.); (Z.B.)
| |
Collapse
|
3
|
Sigman EJ, Laghari FJ, Sarwal A. Neuro Point-of-Care Ultrasound. Semin Ultrasound CT MR 2024; 45:29-45. [PMID: 38070756 DOI: 10.1053/j.sult.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
As the scope of point-of-care ultrasound (POCUS) expands in clinical medicine, its application in neurological applications offers a non-invasive, bedside diagnostic tool. With historical insights, detailed techniques and clinical applications, the chapter provides a comprehensive overview of neurology-based POCUS. It examines the applications, emphasizing its role when traditional neuroimaging is inaccessible or unsafe as well advocating for its use as an adjunctive tool, rather than a replacement of advanced imaging. The chapter covers a range of uses of neuro POCUS including assessment of midline shift, intracranial hemorrhage, hydrocephalus, vasospasm, intracranial pressure, cerebral circulatory arrest, and ultrasound-guided lumbar puncture.
Collapse
Affiliation(s)
- Erika J Sigman
- Neurocritical Care, Department of Neurology, Emory University School of Medicine, Atlanta, GA.
| | - Fahad J Laghari
- Neuroendovascular Surgery, Department of Neurosurgery, Carondelet Neurological Institute, Tucson, AZ
| | - Aarti Sarwal
- Neurocritical Care, Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC
| |
Collapse
|
4
|
Shih CM, Lee CH, Chen KH, Pan CC, Yen YC, Wang CH, Su KC. Optimizing Spinal Fusion Cage Design to Improve Bone Substitute Filling on Varying Disc Heights: A 3D Printing Study. Bioengineering (Basel) 2023; 10:1250. [PMID: 38002375 PMCID: PMC10669701 DOI: 10.3390/bioengineering10111250] [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: 09/15/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
The success of spinal fusion surgery relies on the precise placement of bone grafts and minimizing scatter. This study aims to optimize cage design and bone substitute filling methods to enhance surgical outcomes. A 3D printed lumbar spine model was utilized to implant 3D printed cages of different heights (8 mm, 10 mm, 12 mm, and 14 mm) filled with BICERA® Bone Graft Substitute mixed with saline. Two filling methods, SG cage (side hole for grafting group, a specially designed innovative cage with side hole, post-implantation filling) and FP cage (finger-packing group, pre-implantation finger packing, traditional cage), were compared based on the weight of the implanted bone substitute. The results showed a significantly higher amount of bone substitute implanted in the SG cage group compared to the FP cage group. The quantity of bone substitute filled in the SG cage group increased with the height of the cage. However, in the FP cage group, no significant difference was observed between the 12 mm and 14 mm subgroups. Utilizing oblique lumbar interbody fusion cages with side holes for bone substitute filling after implantation offers several advantages. It reduces scatter and increases the amount of implanted bone substitute. Additionally, it effectively addresses the challenge of insufficient fusion surface area caused by gaps between the cage and endplates. The use of cages with side holes facilitates greater bone substitute implantation, ultimately enhancing the success of fusion. This study provides valuable insights for future advancements in oblique lumbar interbody fusion cage design, highlighting the effectiveness of using cages with side holes for bone substitute filling after implantation.
Collapse
Affiliation(s)
- Cheng-Min Shih
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung 407, Taiwan; (C.-M.S.); (C.-H.L.); (K.-H.C.); (C.-C.P.)
- Department of Physical Therapy, Hungkuang University, Taichung 433, Taiwan
| | - Cheng-Hung Lee
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung 407, Taiwan; (C.-M.S.); (C.-H.L.); (K.-H.C.); (C.-C.P.)
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
| | - Kun-Hui Chen
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung 407, Taiwan; (C.-M.S.); (C.-H.L.); (K.-H.C.); (C.-C.P.)
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
| | - Chien-Chou Pan
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung 407, Taiwan; (C.-M.S.); (C.-H.L.); (K.-H.C.); (C.-C.P.)
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
- Department of Rehabilitation Science, Jenteh Junior College of Medicine, Nursing and Management, Miaoli 356, Taiwan
| | - Yu-Chun Yen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 407, Taiwan; (Y.-C.Y.); (C.-H.W.)
| | - Chun-Hsiang Wang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 407, Taiwan; (Y.-C.Y.); (C.-H.W.)
| | - Kuo-Chih Su
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 407, Taiwan; (Y.-C.Y.); (C.-H.W.)
- Department of Biomedical Engineering, HungKuang University, Taichung 433, Taiwan
- Department of Chemical and Materials Engineering, Tunghai University, Taichung 407, Taiwan
| |
Collapse
|
5
|
Makvandi P, Shabani M, Rabiee N, Anjani QK, Maleki A, Zare EN, Sabri AHB, De Pasquale D, Koskinopoulou M, Sharifi E, Sartorius R, Seyedhamzeh M, Bochani S, Hirata I, Paiva-Santos AC, Mattos LS, Donnelly RF, Mattoli V. Engineering and Development of a Tissue Model for the Evaluation of Microneedle Penetration Ability, Drug Diffusion, Photothermal Activity, and Ultrasound Imaging: A Promising Surrogate to Ex Vivo and In Vivo Tissues. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2210034. [PMID: 36739591 DOI: 10.1002/adma.202210034] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/13/2023] [Indexed: 05/05/2023]
Abstract
Driven by regulatory authorities and the ever-growing demands from industry, various artificial tissue models have been developed. Nevertheless, there is no model to date that is capable of mimicking the biomechanical properties of the skin whilst exhibiting the hydrophilicity/hydrophobicity properties of the skin layers. As a proof-of-concept study, tissue surrogates based on gel and silicone are fabricated for the evaluation of microneedle penetration, drug diffusion, photothermal activity, and ultrasound bioimaging. The silicone layer aims to imitate the stratum corneum while the gel layer aims to mimic the water-rich viable epidermis and dermis present in in vivo tissues. The diffusion of drugs across the tissue model is assessed, and the results reveal that the proposed tissue model shows similar behavior to a cancerous kidney. In place of typical in vitro aqueous solutions, this model can also be employed for evaluating the photoactivity of photothermal agents since the tissue model shows a similar heating profile to skin of mice when irradiated with near-infrared laser. In addition, the designed tissue model exhibits promising results for biomedical applications in optical coherence tomography and ultrasound imaging. Such a tissue model paves the way to reduce the use of animals testing in research whilst obviating ethical concerns.
Collapse
Affiliation(s)
- Pooyan Makvandi
- Centre for Materials Interfaces, Istituto Italiano di Tecnologia, viale Rinaldo Piaggio 34, Pontedera, 56025, Pisa, Italy
- School of Engineering, Institute for Bioengineering, The University of Edinburgh, Edinburgh, EH9 3JL, UK
| | - Majid Shabani
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, 56025, Pisa, Italy
- Bioinspired Soft Robotics Laboratory, Istituto Italiano di Tecnologia, 16163, Genova, Italy
| | - Navid Rabiee
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA 6150, Australia
- School of Engineering, Macquarie University, Sydney, New South Wales, 2109, Australia
| | - Qonita Kurnia Anjani
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Aziz Maleki
- Zanjan Pharmaceutical, Nanotechnology Research Center (ZPNRC), Department of Pharmaceutical Nanotechnology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, 45139-56184, Iran
| | | | | | - Daniele De Pasquale
- Centre for Materials Interfaces, Istituto Italiano di Tecnologia, viale Rinaldo Piaggio 34, Pontedera, 56025, Pisa, Italy
| | - Maria Koskinopoulou
- Department of Advanced Robotics (ADVR), Istituto Italiano di Tecnologia, 16163, Genova, Italy
| | - Esmaeel Sharifi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, 65178-38736, Iran
| | - Rossella Sartorius
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), 80131, Naples, Italy
| | - Mohammad Seyedhamzeh
- Zanjan Pharmaceutical, Nanotechnology Research Center (ZPNRC), Department of Pharmaceutical Nanotechnology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, 45139-56184, Iran
| | - Shayesteh Bochani
- Zanjan Pharmaceutical, Nanotechnology Research Center (ZPNRC), Department of Pharmaceutical Nanotechnology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, 45139-56184, Iran
| | - Ikue Hirata
- Centre for Materials Interfaces, Istituto Italiano di Tecnologia, viale Rinaldo Piaggio 34, Pontedera, 56025, Pisa, Italy
| | - Ana Cláudia Paiva-Santos
- Department of Pharmaceutical Technology, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Azinhaga Sta. Comba, Coimbra, 3000-548, Portugal
- LAQV, REQUIMTE, Department of Pharmaceutical Technology, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Azinhaga Sta. Comba, Coimbra, 3000-548, Portugal
| | - Leonardo S Mattos
- Department of Advanced Robotics (ADVR), Istituto Italiano di Tecnologia, 16163, Genova, Italy
| | - Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Virgilio Mattoli
- Centre for Materials Interfaces, Istituto Italiano di Tecnologia, viale Rinaldo Piaggio 34, Pontedera, 56025, Pisa, Italy
| |
Collapse
|
6
|
Albin CSW, Greene JP, LaHue SC, Kandiah P, Kurzweil AM, Mikhaeil-Demo Y, Morris NA. Reviews in Medical Education: Advances in Simulation to Address New Challenges in Neurology. NEUROLOGY. EDUCATION 2023; 2:e200042. [PMID: 39411112 PMCID: PMC11473088 DOI: 10.1212/ne9.0000000000200042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/29/2022] [Indexed: 10/19/2024]
Abstract
Simulation is an engaging modality of medical education that leverages adult learning theory. Since its inception, educators have used simulation to train clinicians in bedside procedures and neurologic emergencies, as well as in communication, teamwork, and leadership skills. Many applications of simulation in neurology are yet to be fully adopted or explored. However, challenges to traditional educational paradigms, such as the shift to competency-based assessments and the need for remote or hybrid platforms, have created an impetus for neurologists to embrace simulation. In this article, we explore how simulation might be adapted to meet these current challenges in neurologic education by reviewing the existing literature in simulation from the field of neurology and beyond. We discuss how simulation can engage neurology trainees who seek interactive, contextualized, on-demand education. We consider how educators can incorporate simulation for competency-based evaluations and procedural training. We foresee a growing role of simulation initiatives that assess bias and promote equity. We also provide tangible solutions that make simulation an educational tool that is within reach for any educator in both high-resource and low-resource settings.
Collapse
Affiliation(s)
- Catherine S W Albin
- From the Department of Neurology (C.S.W.A., P.K.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (J.P.G., S.C.L.), School of Medicine, and Department of Neurology (S.C.L.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Neurology (A.M.K.), NYU Grossman School of Medicine, New York; Department of Neurology (Y.M.-D.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Program in Trauma (N.A.M.), Department of Neurology, University of Maryland School of Medicine, Baltimore
| | - J Palmer Greene
- From the Department of Neurology (C.S.W.A., P.K.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (J.P.G., S.C.L.), School of Medicine, and Department of Neurology (S.C.L.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Neurology (A.M.K.), NYU Grossman School of Medicine, New York; Department of Neurology (Y.M.-D.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Program in Trauma (N.A.M.), Department of Neurology, University of Maryland School of Medicine, Baltimore
| | - Sara C LaHue
- From the Department of Neurology (C.S.W.A., P.K.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (J.P.G., S.C.L.), School of Medicine, and Department of Neurology (S.C.L.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Neurology (A.M.K.), NYU Grossman School of Medicine, New York; Department of Neurology (Y.M.-D.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Program in Trauma (N.A.M.), Department of Neurology, University of Maryland School of Medicine, Baltimore
| | - Prem Kandiah
- From the Department of Neurology (C.S.W.A., P.K.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (J.P.G., S.C.L.), School of Medicine, and Department of Neurology (S.C.L.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Neurology (A.M.K.), NYU Grossman School of Medicine, New York; Department of Neurology (Y.M.-D.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Program in Trauma (N.A.M.), Department of Neurology, University of Maryland School of Medicine, Baltimore
| | - Arielle M Kurzweil
- From the Department of Neurology (C.S.W.A., P.K.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (J.P.G., S.C.L.), School of Medicine, and Department of Neurology (S.C.L.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Neurology (A.M.K.), NYU Grossman School of Medicine, New York; Department of Neurology (Y.M.-D.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Program in Trauma (N.A.M.), Department of Neurology, University of Maryland School of Medicine, Baltimore
| | - Yara Mikhaeil-Demo
- From the Department of Neurology (C.S.W.A., P.K.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (J.P.G., S.C.L.), School of Medicine, and Department of Neurology (S.C.L.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Neurology (A.M.K.), NYU Grossman School of Medicine, New York; Department of Neurology (Y.M.-D.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Program in Trauma (N.A.M.), Department of Neurology, University of Maryland School of Medicine, Baltimore
| | - Nicholas A Morris
- From the Department of Neurology (C.S.W.A., P.K.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (J.P.G., S.C.L.), School of Medicine, and Department of Neurology (S.C.L.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Neurology (A.M.K.), NYU Grossman School of Medicine, New York; Department of Neurology (Y.M.-D.), Northwestern University Feinberg School of Medicine, Chicago, IL; and Program in Trauma (N.A.M.), Department of Neurology, University of Maryland School of Medicine, Baltimore
| |
Collapse
|
7
|
Madden M, Collins R, Schwarz T, Suñol A. Use of 3D Printing Technology to Create a Canine Simulator for Cerebrospinal Fluid Sampling at the Lumbar Subarachnoid Space. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 50:e20210159. [PMID: 35862374 DOI: 10.3138/jvme-2021-0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Cerebrospinal fluid (CSF) sampling at the lumbar subarachnoid space (LSS) is technically challenging to learn. Currently, training relies on cadaver availability or performance in a clinical scenario. This study aims to develop and validate a low-cost, high-fidelity simulator to train in this technique. Using three-dimensional printing technology, a model of a healthy adult dog's lumbosacral vertebral column was produced. The model was augmented with synthetic materials and a fluidic system to replicate all procedural steps and permit successful CSF collection. The simulator was validated by four experts, who rated it highly across multiple criteria. Final-year veterinary students were recruited to take part in practical sessions using either the simulator (n = 16) or a cadaver (n = 16). Performance was recorded for each student, and feedback was obtained using an anonymous online survey. Student performance was similar between groups (p = .2), with 87.5% and 68.75% of students in the simulator and cadaver group, respectively, successfully placing the needle into the LSS. All successful students in the simulator group were able to obtain a CSF sample, versus none in the cadaver group. No difference in the number of attempts was detected between groups (p > .99), with most students taking more than three attempts. User experience was similar between groups, with 93.8% of students in each group rating the session as a positive learning experience. In summary, we demonstrate the validity of a novel, low-cost, and anatomically precise simulator that can be used for teaching CSF sampling at the LSS.
Collapse
|
8
|
Hu P, Sun J, Wei F, Liu X. Patient-Tailored 3D-Printing Models in the Subspecialty Training of Spinal Tumors: A Comparative Study and Questionnaire Survey. World Neurosurg 2022; 161:e488-e494. [PMID: 35189420 DOI: 10.1016/j.wneu.2022.02.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/11/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Training in the subspecialty of spinal tumors is challenging and less researched. The anatomic variations and complex relationship with paraspinal structures tend to be the main obstacle for the trainees in this field. Three-dimensional (3D)-printing technique has the advantage of individual customization and high fidelity, and can produce case-tailored models as auxiliary tools in medical training. METHODS The main parts of the study included case-based lectures with tailored 3D-printing models, evaluating their performances in a controlled examination and anonymous questionnaire survey regarding the trainees' opinion towards the tailored models. The examination was designed as case-based clinical analysis. All trainees were randomly allocated to the study group and control group, and the former group was additively provided a case-tailored model. RESULTS Thirty-six participants were recruited in this study, including 16 residents and 20 fellows. In the section of examination, there was significant difference in the aspects of describing the involvement of paraspinal structures and discriminating the relationship between the tumor and large vessels (P < 0.05), but similar in the aspects of surgical planning and relevant complications (P > 0.05). In the survey, most participants gave favorable responses to 3D-printing models in the aspects of understanding anatomic structures and relationship, inter-trainee communication, surgical planning, and enhancement of interest and confidence (50.0% to 94.4%, respectively). CONCLUSIONS The 3D-printing model is a valuable tool in the training of new residents and fellows in the subspecialty of spinal tumors. It can facilitate the trainees' understanding of tumor anatomy, surgical readiness, and confidence as well.
Collapse
Affiliation(s)
- Panpan Hu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| | - Jie Sun
- Pain Medicine Center, Peking University Third Hospital, Beijing, China
| | - Feng Wei
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China.
| | - Xiaoguang Liu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| |
Collapse
|
9
|
Meyer-Szary J, Luis MS, Mikulski S, Patel A, Schulz F, Tretiakow D, Fercho J, Jaguszewska K, Frankiewicz M, Pawłowska E, Targoński R, Szarpak Ł, Dądela K, Sabiniewicz R, Kwiatkowska J. The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals-Cross-Sectional Multispecialty Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3331. [PMID: 35329016 PMCID: PMC8953417 DOI: 10.3390/ijerph19063331] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/18/2022] [Accepted: 03/05/2022] [Indexed: 12/19/2022]
Abstract
Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and education, development of surgical guides and other tools, patient-specific implants, bioprinted organs or structures, and counseling of patients. It was evident that pre-procedural planning and rehearsing of unusual or difficult procedures and training of medical professionals in these procedures are extremely useful and transformative.
Collapse
Affiliation(s)
- Jarosław Meyer-Szary
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Marlon Souza Luis
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- First Doctoral School, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Szymon Mikulski
- Department of Head and Neck Surgery, Singapore General Hospital, Singapore 169608, Singapore
| | - Agastya Patel
- First Doctoral School, Medical University of Gdańsk, 80-211 Gdańsk, Poland
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Finn Schulz
- University Clinical Centre in Gdańsk, 80-952 Gdańsk, Poland
| | - Dmitry Tretiakow
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Justyna Fercho
- Neurosurgery Department, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Kinga Jaguszewska
- Department of Gynecology, Obstetrics and Neonatology, Division of Gynecology and Obstetrics, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Mikołaj Frankiewicz
- Department of Urology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Ewa Pawłowska
- Department of Oncology and Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Radosław Targoński
- 1st Department of Cardiology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Łukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, Poland
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Katarzyna Dądela
- Department of Pediatric Cardiology, University Children's Hospital, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Robert Sabiniewicz
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Joanna Kwiatkowska
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| |
Collapse
|
10
|
Hampel H, Shaw LM, Aisen P, Chen C, Lleó A, Iwatsubo T, Iwata A, Yamada M, Ikeuchi T, Jia J, Wang H, Teunissen CE, Peskind E, Blennow K, Cummings J, Vergallo A. State-of-the-art of lumbar puncture and its place in the journey of patients with Alzheimer's disease. Alzheimers Dement 2021; 18:159-177. [PMID: 34043269 PMCID: PMC8626532 DOI: 10.1002/alz.12372] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/24/2021] [Accepted: 04/12/2021] [Indexed: 01/01/2023]
Abstract
Recent advances in developing disease‐modifying therapies (DMT) for Alzheimer's disease (AD), and the recognition that AD pathophysiology emerges decades before clinical symptoms, necessitate a paradigm shift of health‐care systems toward biomarker‐guided early detection, diagnosis, and therapeutic decision‐making. Appropriate incorporation of cerebrospinal fluid biomarker analysis in clinical practice is an essential step toward system readiness for accommodating the demand of AD diagnosis and proper use of DMTs—once they become available. However, the use of lumbar puncture (LP) in individuals with suspected neurodegenerative diseases such as AD is inconsistent, and the perception of its utility and safety differs considerably among medical specialties as well as among regions and countries. This review describes the state‐of‐the‐art evidence concerning the safety profile of LP in older adults, discusses the risk factors for LP‐associated adverse events, and provides recommendations and an outlook for optimized use and global implementation of LP in individuals with suspected AD.
Collapse
Affiliation(s)
- Harald Hampel
- Eisai Inc., Neurology Business Group, Woodcliff Lake, New Jersey, USA
| | - Leslie M Shaw
- Perelman School of Medicine, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paul Aisen
- USC Alzheimer's Therapeutic Research Institute, San Diego, California, USA
| | - Christopher Chen
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alberto Lleó
- Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau-Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Takeshi Iwatsubo
- Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Atsushi Iwata
- Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaecho, Itabashi-ku, Tokyo, Japan
| | - Masahito Yamada
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Asahimachi, Niigata, Japan
| | - Jianping Jia
- Innovation Center for Neurological Disorders, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Huali Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Beijing, China
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Elaine Peskind
- VA Northwest Mental Illness Research, Education and Clinical Center, VA Puget Sound Health Care System, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada, USA
| | - Andrea Vergallo
- Eisai Inc., Neurology Business Group, Woodcliff Lake, New Jersey, USA
| |
Collapse
|
11
|
Abeysekera N, Whitmore KA, Abeysekera A, Pang G, Laupland KB. Applications of 3D printing in critical care medicine: A scoping review. Anaesth Intensive Care 2021; 49:164-172. [PMID: 33789504 DOI: 10.1177/0310057x20976655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although a wide range of medical applications for three-dimensional printing technology have been recognised, little has been described about its utility in critical care medicine. The aim of this review was to identify three-dimensional printing applications related to critical care practice. A scoping review of the literature was conducted via a systematic search of three databases. A priori specified themes included airway management, procedural support, and simulation and medical education. The search identified 1544 articles, of which 65 were included. Ranging across many applications, most were published since 2016 in non - critical care discipline-specific journals. Most studies related to the application of three-dimensional printed models of simulation and reported good fidelity; however, several studies reported that the models poorly represented human tissue characteristics. Randomised controlled trials found some models were equivalent to commercial airway-related skills trainers. Several studies relating to the use of three-dimensional printing model simulations for spinal and neuraxial procedures reported a high degree of realism, including ultrasonography applications three-dimensional printing technologies. This scoping review identified several novel applications for three-dimensional printing in critical care medicine. Three-dimensional printing technologies have been under-utilised in critical care and provide opportunities for future research.
Collapse
Affiliation(s)
- Natasha Abeysekera
- Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Kirsty A Whitmore
- Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Australia.,Faculty of Medicine, University of Queensland, Herston, Australia
| | - Ashvini Abeysekera
- Otolaryngology and Head and Neck Surgery, Royal Brisbane and Women's Hospital, Herston, Australia
| | - George Pang
- Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Kevin B Laupland
- Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Australia.,Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Australia
| |
Collapse
|
12
|
Juneja P, Frenkel MB, Carmichael SP, Sarwal A. Gray-Scale Sonography of the Spinal Cord in Postlaminectomy Patient. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2021. [DOI: 10.1177/8756479320972099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Laminectomy, a common neurosurgical procedure that decompresses the spinal cord, is the definitive surgical treatment for spinal epidural abscesses. Although complications after laminectomy occur infrequently, they can cause significant morbidity and health care resource usage. These complications include soft tissue collections like a persistent and/or new abscess or a hematoma. The preferred method of diagnosis for spinal soft tissue collections is magnetic resonance imaging. However, traditional neuroimaging poses significant challenges in patients with spinal hardware due to metallic artifact precluding appropriate visualization of anatomy and pathology. This was a case of a patient with extensive spinal hardware where visualization of the spinal cord by postoperative sonography was made feasible by a lack of bone after a laminectomy. Point-of-care ultrasound, a convenient bedside tool with the ability to detect soft tissue collections easily, was used to monitor for postoperative recurrence of a spinal epidural abscess in this patient. Patients with an intact spine do not have adequate acoustic windows due to posterior vertebral anatomy. In postlaminectomy patients without posterior vertebral structures, sonography may offer a diagnostic modality for postoperative monitoring. Ultrasonographers can employ spinal cord sonography, particularly when the indication for decompressive laminectomy was a localized fluid collection or abscess.
Collapse
Affiliation(s)
| | - Mark B. Frenkel
- Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Sam P. Carmichael
- Department of General Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Aarti Sarwal
- Department of Neurology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| |
Collapse
|