The second group was designated the вЂњControl group,вЂќ and was scheduled to receive only one training session. One group was designated the вЂњTraining group,вЂќ and was scheduled to receive two procedural training sessions using the lumbar spine phantom. Thirteen first and second year medical student participants with no prior experience in CT-guided minimally-invasive spine procedures were randomly assigned to two groups. This study was granted exemption by the Institutional Review Board of the University of California, San Francisco. In this study, we evaluate the efficacy of using such a spine model to improve novice trainee confidence and proficiency in performing CT-guided facet joint injections. Based on these factors, we created a 3D printed model of a degenerative lumbosacral spine with scoliosis and spondylosis, using materials that mimic bone and soft tissue density under CT.

Commercially-available spine phantom models often lack the degenerative anatomic details that make real-life procedures challenging. The use of a phantom spine model for training CT-guided spine procedures would reduce patient risk and radiation exposure during the training process. Several prior studies have described the creation and usage of phantom models in the training of imaging-guided needle-based procedures and surgical procedures, such as minimally invasive arthroscopy. Additionally, errors in proficiency made by trainees who have not yet developed technical expertise in these procedures may lead to unnecessary patient risk.Дespite the increased performance of these imaging-guided minimally-invasive spine procedures over the past decade, few studies to date have described effective methods of teaching such procedures to novice operators. Learning such procedures on real patients may subject patients to a greater than necessary number of needle readjustments in order to obtain the proper needle positioning, ultimately resulting in a longer procedure and a higher radiation dose. Novice trainees usually learn to perform such procedures through real-time interactions with patients, under the supervision of an experienced operator. Imaging guidance with CT or fluoroscopy allows for direct visualization of needle trajectory and eventual needle endpoint.Д¬ompetence in these procedures is acquired through experience and training. Minimally-invasive computed tomography (CT)- or fluoroscopically-guided spine procedures are commonly performed in radiology departments to provide targeted, individualized diagnosis and pain management for patients. Training using a realistic lumbosacral spine model helps novices acquire the skills and confidence to perform CT-guided spine procedures. ConclusionДЄ 3D printed lumbosacral spine phantom with realistic spondylosis can be made to facilitate novice training in minimally-invasive spine procedures. Both groups demonstrated significant increase in confidence in ability to perform CT-guided spine procedures on the post-test ( p = 0.004 for the Control group and p = 0.00001 for the Training group). The Training group demonstrated significantly fewer needle readjustments during the second simulation session, compared with the first session ( p = 0.005).

The Control group (6 students) received only one training session.

The Training group (7 students) received two separate training sessions using the simulation model. Both groups received an introductory didactic lecture, as well as identical pre- and post- test assessments. Thirteen medical students with no prior exposure to CT-guided spine procedures were divided into two groups. We created a 3D printed model of a degenerative lumbosacral spine with scoliosis and spondylosis, using materials that mimic bone and soft tissue density under CT. Competence in these procedures is acquired through experience and training. Minimally-invasive spine procedures provide targeted, individualized diagnosis and pain management for patients.

Phantom pain management algorithm