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The Development of a Reusable, Inexpensive Lumbar Spine Phantom for Teaching Image-guided Intervention 2014

Category Interventional Austin C. Bourgeois, MD, BS Austin R. Faulkner, MD, MSC, BS Thomas McLaren, MD, BS Darrell Benton, MD, BS Yong Bradley, MD Alexander Pasciak, PhD, BS Purpose Fluoroscopically-guided needle placement is an essential skill taught to nearly every radiology resident. Procedures in the lumbar spine such as image-guided lumbar puncture (LP) and facet injection are commonly performed examples of this technique. Radiology trainees often learn to perform these procedures via hands-on training, and initial attempts may be performed without expert knowledge of bony landmarks or experience with image guidance equipment. The prohibitively expensive nature of the few commercially available and fluoroscopically-compatible training models, which can exceed $3,500.00 in cost, likely contributes to this. We describe the creation of an inexpensive, reusable, and easily reproducible phantom for use in conjunction with a formal education curriculum for teaching fluoroscopically-guided lumbar puncture. Materials & Methods The synthetic tissue substitute was made by melting approximately 14 lbs of commercially available, transparent ballistic gel ($94.00) at 260 degrees for 1 hour. An anatomically accurate PVC lumbar spine model was assembled with a radiolucent nylon screw ($5.95), immersed in the liquefied gel, and allowed to cool at room temperature for approximately 6 hours. The model and gel were contained within a 6’’ deep stainless steel food service tray ($15.60) during the heating and cooling process. Results This anatomically and fluoroscopically bioequivalent lumbar spine phantom was created in 8 hours and at a fraction of the cost associated with the few commercially available products. The phantom is reproducible in a reasonable period of time and a relatively minor financial investment. Conclusion This educational exhibit explores the synthesis of several months of trial-and-error in the creation of a lumbar spine phantom that is easily reproducible, durable, reusable, inexpensive, and possesses accurate anatomic detail under fluoroscopy. This model is utilized as part of a formal educational curriculum in our department aimed at reducing fluoroscopy time and improving resident confidence with image-guided lumbar puncture. We provide pictorial directions of the lumbar spine phantom creation process and suggestions of other ways to utilize this technology for resident education. References 1. Gorelick PB, Biller J. Lumbar puncture. Technique, indications, and complications. Postgrad Med 1986; 79 (8): 257–268. 2. Roos KL. Lumbar puncture. Semin Neurol 2003; 23 (1): 105–114.