A do-it-yourself 3D-printed thoracic spine model for anesthesia resident simulation

Figures

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  Fig 1. Steps in model fabrication. Fabrication of 3D-printed thoracic vertebrae and discs (A), vertebrae and discs epoxied together (B), ligamentum flavum and mold (C), ligamentum flavum secured to bubble tea straw with duct tape (D), ligament and bubble tea straw shown within vertebral canal (E).

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  Fig 2. 3D-printed model. Thoracic epidural model (A) and trainee practicing thoracic epidural placement (B).

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  Fig 3. Anesthesia attendings’ assessment of model fidelity. Question 1. How realistic is the visual representation of the thoracic spine anatomy T7-T11? Question 2. How realistic does the soft tissue feel? Question 3. How realistic does the bone feel? Question 4. How realistic does the ligamentum flavum feel? Question 5. How realistic does the loss of resistance feel? Question 6. How useful do you think the model is as a teaching tool?

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  Fig 4. Anesthesia attendings’ perspective on the difficulty of various steps for novice residents learning thoracic epidural placement. Statement 1. Identifying landmarks on back / identifying different thoracic levels. Statement 2. Determining where to place needle on patient’s back and determining needle approach. Statement 3. How to feel and identify the different layers with needle (soft tissue, bone, ligamentum flavum). Statement 4. How to mentally visualize the location of the needle tip with redirection at skin. Statement 5. How to feel the “loss of resistance”.

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  Fig 5. Anesthesia residents’ assessment of the model. Statement 1. The thoracic epidural model helps me feel different tissue layers of soft tissue, bone, ligamentum flavum. Statement 2. The thoracic epidural model helps me visualize location of the needle tip with redirection at skin surface. Statement 3. The thoracic epidural model helps me improve manual dexterity for epidural needle placement. Statement 4. The thoracic epidural model helps me learn the feeling of loss of resistance. Statement 5. The thoracic epidural model helps me prepare for epidural placement in a patient.

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  Fig 6. Ultrasound images obtained from the model. Transverse view (A) and paramedian view (B).