Experimental Model for Interlaminar Endoscopic Spine Procedures

Area of Science:

• Neurosurgery
• Surgical Training
• Anatomical Modeling

Background:

• Endoscopic spinal surgery is increasingly popular, necessitating effective training models.
• Limited availability of human cadavers hinders surgical skill development.
• The porcine spine is evaluated as a potential cadaver model for endoscopic lumbar procedures.

Purpose of the Study:

• To assess the suitability of the porcine spine for learning and practicing interlaminar percutaneous endoscopic lumbar procedures (IL-PELPs).

Main Methods:

• Lumbar and cervical porcine spine segments were utilized for IL-PELP training.
• Technical notes on procedural difficulties and anatomical features were documented.
• Five neurosurgeons trained for one day and completed a post-training survey.

Main Results:

• Porcine lumbar spines feature small interlaminar windows requiring laminectomy, similar to higher human lumbar levels.
• Porcine cervical spines offer wide interlaminar windows, mimicking the human L5-S1 approach.
• Key maneuvers like canal entry and disc access were possible in the lumbar segment; flavectomy and neural structure identification were feasible in both segments.

Conclusions:

• The porcine spine serves as an effective and representative model for IL-PELP training.
• Known anatomical variations in the porcine model do not impede the execution of essential surgical steps.