Development of a Patient-specific Guide for High Cervical Spine Fixation

Assessment of the accuracy of patient-specific drilling guides for cervical (C5-C6) and lumbar (L4-L5) vertebrae in cats

Ten sets of vertebral biomodels and the corresponding drilling guides were created to evaluate the implantation accuracy in the cervical (C5-C6) and lumbar (L4-L5) vertebrae of cats. Smooth pins were implanted using the guides on the right side of five randomly assigned biomodel sets and on the left side of the remaining sets, with the contralateral side undergoing freehand implantation. Subsequently, a new tomographic study was conducted to measure the implantation angles. The pre-implantation angles were compared with the post-implantation angles between the techniques and among the sets. The guide-assisted implantation exhibited a lower dispersion compared to the freehand technique, with coefficients of variation of -1.95 and 48.9 in the cervical vertebrae and 1.98 and 9.39 in the lumbar vertebrae, respectively. However, no statistical difference was observed between the pre- and post-implantation angles, nor when comparing the vertebral segments (P > 0.05). Under the study conditions, the use of the guide failed to result in more accurate implantations in the C5-C6 and L4-L5 vertebral biomodels of cats.

Neurosurgical simulation models developed in Latin America and the Caribbean: a scoping review

Simulation training is an educational tool that provides technical and cognitive proficiency in a risk-free environment. Several models have recently been presented in Latin America and the Caribbean (LAC). However, many of them were presented in non-indexed literature and not included in international reviews. This scoping review aims to describe the simulation models developed in LAC for neurosurgery training. Specifically, it focuses on assessing the models developed in LAC, the simulated neurosurgical procedures, the model's manufacturing costs, and the translational outcomes. Simulation models developed in LAC were considered, with no language or time restriction. Cadaveric, ex vivo, animal, synthetic, and virtual/augmented reality models were included for cranial and spinal procedures. We conducted a review according to the PRISMA-ScR, including international and regional reports from indexed and non-indexed literature. Two independent reviewers screened articles. Conflicts were resolved by a third reviewer using Covidence software. We collected data regarding the country of origin, recreated procedure, type of model, model validity, and manufacturing costs. Upon screening 917 studies, 69 models were developed in LAC. Most of them were developed in Brazil (49.28%). The most common procedures were related to general neurosurgery (20.29%), spine (17.39%), and ventricular neuroendoscopy and cerebrovascular (15.94% both). Synthetic models were the most frequent ones (38.98%). The manufacturing cost ranged from 4.00 to 2005.00 US Dollars. To our knowledge, this is the first scoping review about simulation models in LAC, setting the basis for future research studies. It depicts an increasing number of simulation models in the region, allowing a wide range of neurosurgical training in a resource-limited setting.