title: A Framework for Patient-Specific Spinal Intervention Simulation: Application to Lumbar Spinal Durotomy Repair.
abstract: We present a functional and patient-specific lumbar phantom for the training of spinal durotomy and dura closure under microscopic view, consisting of a lumbar model, pressurized dural surrogate, together immersed in a tissue-mimicking layer simulating fat, muscle and skin. The lumbar model was derived from a patient computed tomography scan, preserving the natural shape and curvature of the lumbar column. The inclusion of the simulated soft-tissue layer was critical for preserving the surgical ergonomics and presented a realistic view under the surgical microscope. As the success of dura repair is indicated by the watertight closure of the thecal sac, the dura surrogate was connected to a pressurized and closed-loop water system to provide functional cerebrospinal fluid leakage during durotomy. This functional phantom is inexpensive to construct, provides a realistic tactile and visual environment for spinal durotomy repair, and can be easily extended to simulate other patient-specific spinal interventions.
authors.affiliation: London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Lau
authors.affiliation: London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Lynn
authors.initials: L
authors.lastname: Denning
authors.affiliation: London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Lownie
authors.affiliation: Robarts Research Institute, London, Ontario, Canada.
authors.forename: Terry M
authors.initials: TM
authors.lastname: Peters
authors.affiliation: Robarts Research Institute, London, Ontario, Canada.
authors.forename: Elvis C S
authors.initials: EC
authors.lastname: Chen
mesh_terms: D004388:Dura Mater / Q000601:surgery*; D004867:Equipment Design; D006801:Humans; D008159:Lumbar Vertebrae; D008348:Manikins; D008953:Models, Anatomic; D019635:Neurosurgical Procedures / Q000193:education* / Q000295:instrumentation*; D066230:Patient-Specific Modeling; D066330:Printing, Three-Dimensional