A Framework for Patient-Specific Spinal Intervention Simulation: Application to Lumbar Spinal Durotomy Repair

Area of Science:

• Neurosurgery
• Medical Simulation
• Anatomical Modeling

Background:

• Spinal durotomy and dura repair are critical surgical procedures.
• Effective training requires realistic anatomical models and simulation of cerebrospinal fluid dynamics.
• Existing training models may lack patient-specificity and functional simulation.

Purpose of the Study:

• To develop a functional, patient-specific lumbar phantom for training spinal durotomy and dura closure.
• To create a realistic surgical environment mimicking tactile and visual feedback.
• To provide a cost-effective and adaptable training tool for spinal interventions.

Main Methods:

• A patient-specific lumbar model was created from computed tomography (CT) scans.
• A pressurized dural surrogate connected to a closed-loop water system simulated cerebrospinal fluid leakage.
• A tissue-mimicking layer simulated fat, muscle, and skin for realistic surgical ergonomics and microscopic view.

Main Results:

• The phantom accurately replicated patient-specific lumbar anatomy and curvature.
• The pressurized dural surrogate provided functional cerebrospinal fluid leakage for durotomy simulation.
• The tissue layer ensured realistic surgical ergonomics and microscopic visualization.

Conclusions:

• The developed phantom offers a realistic, functional, and patient-specific training environment for spinal durotomy and dura repair.
• This cost-effective model enhances surgical training by simulating key aspects of the procedure.
• The phantom's design is adaptable for simulating other patient-specific spinal interventions.