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Teaching Fluoroscopic Neuroanatomy And Spine Injection Skills Using A Modified Plastic Model Of The Lumbar Spine 2013

Category Interventional Jonathan Musco
Ashish Nanda
Ryan Davis
Purpose Learning and understanding fluoroscopic neuroanatomy and acquiring the skills to safely perform spine injections is an essential part of training for many radiology, neurology, neurosurgery, anesthesia, and physical medicine and rehabilitation residents.  Unfortunately there are no inexpensive and easily accessible models available to simulate and teach this essential skill.  Thus, much of the teaching and learning is done while the patient is on the fluoroscopy table using the “See one, do one, teach one” method. Materials & Methods We present a novel cost effective approach to making a fluoroscopic simulator using a plastic spine model coated with a metallic adhesive.  The model is then wrapped in a gel foam pillow to provide stability for the spinal needle and to block the trainees view of the model.  After reviewing general lumbar neuroanatomy using images obtained from the model, the trainees were provided with instructions on use of the fluoroscopy camera and basic needle handling technique and placement.  The trainees then performed a series of mock procedures using the model.  The mock procedures were monitored for total procedure time, total fluoroscopy time, and accuracy of needle placement. Results All trainees showed a statistically significant improvement in total procedure time, total fluoroscopy time, and accuracy of needle placement.  After performing the mock procedures, trainees were more confident and felt as though they were now better prepared to perform the procedures on actual patients. Conclusion We were able to transform an inexpensive plastic model of the lumbar spine into a useful neuroanatomy fluoroscopic simulator device that can be used to teach fluoroscopic neuroanatomy and spine injection skills without subjecting patients to multiple needle placement attempts and unnecessary radiation. References None.