A practical laboratory study simulating the percutaneous lumbar transforaminal epidural injection: training model in fresh cadaveric sheep spine

Süslü, Hüsnü

doi:10.5137/1019-5149.jtn.5899-12.2

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…In addition, the same author performed two other spinal procedures on sheep spines, namely a percutaneous lumbar transforaminal epidural injection [22], and a laboratory pedicular screw fixation [23]. The epidural injection is a procedure through which a steroid is injected into the intervertebral foramen, and it is used for lumbar disc pathology with intense pain.…”

Section: Ovine Modelsmentioning

confidence: 99%

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Morosanu

Nicolae

Moldovan

et al. 2018

Neurol Neurochir Pol.

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Introduction. Due to its high complexity, neurosurgery consists of a demanding learning curve that requires intense training and a deep knowledge of neuroanatomy. Microsurgical skill development can be achieved through various models of simulation, but as human cadaveric models are not always accessible, cadaveric animal models can provide a reliable environment in which to enhance the acquisition of surgical dexterity. The aim of this review was to analyse the current role of animal brains in laboratory training and to assess their correspondence to the procedures performed in humans. Material and methods. A Pubmed literature search was performed to identify all the articles concerning training cranial and spinal techniques on large animal heads. The search terms were 'training model' , and 'neurosurgery' in association with 'animal' , 'sheep' , 'cow' , and 'swine'. The exclusion criteria were articles that were on human brains, experimental fundamental research, or on virtual simulators. Results. The search retrieved 119 articles, of which 25 were relevant to the purpose of this review. Owing to their similar neuroanatomy, bovine, porcine and ovine models prove to be reliable structures in simulating neurosurgical procedures. On bovine skulls, an interhemispheric transcalosal and retrosigmoid approach along with different approaches to the Circle of Willis can be recreated. Ovine model procedures have varied from lumbar discectomies on sheep spines to craniosynostosis surgery, whereas in ex vivo swine models, cadaveric dissections of lateral sulcus, median and posterior fossa have been achieved. Conclusions. Laboratory training models enhance surgical advancements by familiarising trainee surgeons with certain neuroanatomical structures and promoting greater surgical dexterity. The accessibility of animal brains allows trainee surgeons to exercise techniques outside the operating theatre, thus optimising outcomes in human surgical procedures.

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Section: Ovine Modelsmentioning

confidence: 99%

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Morosanu

Nicolae

Moldovan

et al. 2018

Neurol Neurochir Pol.

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“…In the last decade, an increasing effort has been made to develop spine surgery training models based on synthetic material 21,53-55 and human and animal cadavers. 51,52 Many of these tools provide excellent support to residents' training, although they are limited to performing surgical approaches on normal surgical anatomy. A great drawback of most of the traditional training models in spine surgery is that they do not expose residents to the distorted anatomical setting encountered in real cases by dealing with pathologic conditions.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, no reports to date have described training models on both extra-and intraaxial spinal tumors as well as degenerative spine pathology (i.e., vertebral disk herniation), with the exception of some pioneering reports on standard cadaveric models. 51,52 This is the one of the first tools to explore the challenges of an ex vivo training tool on spine surgery, based on the application of a polymer in the cadaveric model closely reproducing the wide spectrum of spinal pathologies.…”

Section: Introductionmentioning

confidence: 99%

Complex Spine Pathology Simulator: An Innovative Tool for Advanced Spine Surgery Training

Gragnaniello

Abou-Hamden

Mortini

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

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Technical advancements in spine surgery have made possible the treatment of increasingly complex pathologies with less morbidity. Time constraints in surgeons' training have made it necessary to develop new training models for spine pathology. To describe the application of a novel compound, Stratathane resin ST-504 derived polymer (SRSDP), that can be injected at different spinal target locations to mimic spinal epidural, subdural extra-axial, and intra-axial pathologies for the use in advanced surgical training. Fresh-frozen thoracolumbar and cervical spine segments of human and sheep cadavers were used to study the model. SRSDP is initially liquid after mixing, allowing it to be injected into target areas where it expands and solidifies, mimicking the entire spectrum of spinal pathologies. Different polymer concentrations have been codified to vary adhesiveness, texture, spread capability, deformability, and radiologic visibility. Polymer injection was performed under fluoroscopic guidance through pathology-specific injection sites that avoided compromising the surgical approach for subsequent excision of the artificial lesion. Inflation of a balloon catheter of the desired size was used to displace stiff cadaveric neurovascular structures to mimic pathology-related mass effect. The traditional cadaveric training models principally only allow surgeons to practice the surgical approach. The complex spine pathology simulator is a novel educational tool that in a user-friendly, low-cost fashion allows trainees to practice advanced technical skills in the removal of complex spine pathology, potentially shortening some of the aspects of the learning curve of operative skills that may otherwise take many years to acquire.

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“…Most recent reports on simulation and resident education in spinal neurosurgery have focused on using sheep, calf, or deer spines. [33281868791] Kalayci et al . described a method to teach classical discectomy skills, as the use of this procedure has decreased in prevalence due to increased morbidity.…”

Section: Methodsmentioning

confidence: 99%

“…have detailed the use of sheep spines for training in pedicle screw fixation, lumbar microdiscectomy, and percutaneous lumbar transforaminal epidural injection. [868788]…”

Section: Methodsmentioning

confidence: 99%

Simulation and resident education in spinal neurosurgery

Bohm

Arnold

2015

Surg Neurol Int

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Background:A host of factors have contributed to the increasing use of simulation in neurosurgical resident education. Although the number of simulation-related publications has increased exponentially over the past two decades, no studies have specifically examined the role of simulation in resident education in spinal neurosurgery.Methods:We performed a structured search of several databases to identify articles detailing the use of simulation in spinal neurosurgery education in an attempt to catalogue potential applications for its use.Results:A brief history of simulation in medicine is given, followed by current trends of spinal simulation utilization in residency programs. General themes from the literature are identified that are integral for implementing simulation into neurosurgical residency curriculum. Finally, various applications are reported.Conclusion:The use of simulation in spinal neurosurgery education is not as ubiquitous in comparison to other neurosurgical subspecialties, but many promising methods of simulation are available for augmenting resident education.

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A practical laboratory study simulating the percutaneous lumbar transforaminal epidural injection: training model in fresh cadaveric sheep spine

Cited by 5 publications

References 13 publications

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Complex Spine Pathology Simulator: An Innovative Tool for Advanced Spine Surgery Training

Simulation and resident education in spinal neurosurgery

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