E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Validation of a 3D-Printed Facet Injection Training Model with Real-Time Feedback: A Prospective Study on Neurosurgical Residents
Hüseyin Biçeroğlu✉ ,
Bilal Bahadır Akbulut ,
Elif Ezgi Çenberlitaş ,
Barış Oğuz Gürses ,
Mustafa Serdar Bölük ,
Taşkın Yurtseven
Neurosurgery, Ege University; Neurosurgery, Bornova Türkan Özilhan Devlet Hastanesi; Department of Neurosurgery, Ege University Faculty of Medicine; Neurosurgery, Ege Universitesi
DOI: 10.5137/1019-5149.JTN.50284-25.3
Article in Press
Corresponding Author:
Hüseyin Biçeroğlu (huseyin.biceroglu@gmail.com)
Abstract
Aim
Pain injections are one of the most commonly done spinal procedures, yet there are no structured and safe platforms for teaching. We aimed to create a low-cost, 3D-printed lumbosacral model with real-time feedback for training residents in lumbar facet joint injections.
Material and Methods
A 3D-printed lumbosacral model was created using barium-enhanced paint for fluoroscopic visibility and graphite-enhanced conductive paint for facet targets. A custom needle system connected to an Arduino-based circuit provided immediate visual and auditory feedback when the needle contacted correct or incorrect targets. Ten neurosurgery residents who had no prior experience with facet injections were involved. They all had three training sessions, which involved bilateral injections at L2-3, L3-4, and L4-5. Outcomes were procedure time, fluoroscopy shots, number of attempts, and complications.
Results
There were significant improvements between sessions. The mean procedure time dropped to 27.5 ± 6.8 minutes in Session 2 and 16.7 ± 4.2 minutes in Session 3, which is a 61% decrease (p < 0.001).Median fluoroscopy use declined from 48 images (IQR: 42-54) in Session 1 to 32 (IQR: 28-38) in Session 2, and 22 (IQR: 18-26) in Session 3 (p < 0.001). Median number of attempts decreased from 16 (IQR: 13-19) in Session 1 to 12 (IQR: 10-14) in Session 2, and 8 (IQR: 6-10) in Session 3 (p < 0.001). There was no significant difference in complications, which is defined as contact with nerve root or spinal canal, among sessions (p = 0.32).
Conclusion
This novel, feedback-enabled, 3D printed model is an effective platform for facet injection training that shows significant results in procedure time, fluoroscopy use, and attempts. In addition to facet injections, the system can then be adapted for other types of spinal procedures such as caudal, epidural, and transforaminal injections. As part of the SpineForge initiative, this open-source model supports the democratization of surgical education.
Pain injections are one of the most commonly done spinal procedures, yet there are no structured and safe platforms for teaching. We aimed to create a low-cost, 3D-printed lumbosacral model with real-time feedback for training residents in lumbar facet joint injections.
Material and Methods
A 3D-printed lumbosacral model was created using barium-enhanced paint for fluoroscopic visibility and graphite-enhanced conductive paint for facet targets. A custom needle system connected to an Arduino-based circuit provided immediate visual and auditory feedback when the needle contacted correct or incorrect targets. Ten neurosurgery residents who had no prior experience with facet injections were involved. They all had three training sessions, which involved bilateral injections at L2-3, L3-4, and L4-5. Outcomes were procedure time, fluoroscopy shots, number of attempts, and complications.
Results
There were significant improvements between sessions. The mean procedure time dropped to 27.5 ± 6.8 minutes in Session 2 and 16.7 ± 4.2 minutes in Session 3, which is a 61% decrease (p < 0.001).Median fluoroscopy use declined from 48 images (IQR: 42-54) in Session 1 to 32 (IQR: 28-38) in Session 2, and 22 (IQR: 18-26) in Session 3 (p < 0.001). Median number of attempts decreased from 16 (IQR: 13-19) in Session 1 to 12 (IQR: 10-14) in Session 2, and 8 (IQR: 6-10) in Session 3 (p < 0.001). There was no significant difference in complications, which is defined as contact with nerve root or spinal canal, among sessions (p = 0.32).
Conclusion
This novel, feedback-enabled, 3D printed model is an effective platform for facet injection training that shows significant results in procedure time, fluoroscopy use, and attempts. In addition to facet injections, the system can then be adapted for other types of spinal procedures such as caudal, epidural, and transforaminal injections. As part of the SpineForge initiative, this open-source model supports the democratization of surgical education.
Keywords
Facet Joint
Spinal Injections
3D printing
Simulation training
Spine