An Open-Source 3D Printed Simulator for Lumbar Durotomy Repair: A Single Neurosurgery Residency Program’s Experience

Introduction Surgical simulation is an appealing adjunct for educating trainees on a variety of spine surgery techniques, especially non-routine skills like lumbar durotomy repair. However, high costs and significant lead time required to obtain surgical simulators restrict their routine use in most training programs. The goal of the present study was to develop and evaluate a low-cost and open-source 3D printed lumbar durotomy repair simulator for resident education.

The design of a pre-existing open-source 3D printed spine simulator was modified for a durotomy repair simulation. The simulator was then printed using acrylonitrile butadiene styrene (ABS) filament on a Bambu Lab P1S printer. Current neurosurgical residents from a single institution were recruited to participate in a one hour lab session in which they were tasked with repairing a standardized 1.5 centimeter durotomy. Subjects were surveyed before and after their simulation experience.

Seven simulators were produced taking on average 12.2 hours to print and cost approximately $9.51 each once fully assembled. Of the 14 subjects recruited, only 7 (50%) reported prior experience with lumbar durotomy repair. All subjects were able to successfully complete the simulated task. Exit survey results demonstrated that all subjects (100%) agreed the simulation was useful and expressed interest in participating in future simulation experiences.

Our study demonstrated a 3D printed simulator for lumbar durotomy repair could be produced at low cost and was highly valued by neurosurgical trainees. Given our simulator’s low cost and open-source format, we believe it is highly accessible to most, if not all, residency programs, and has the potential to help expedite mastery of lumbar durotomy repair. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study was partially funded by Cleveland Clinic Foundation Catalyst Grant. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/IRB of Cleveland Clinic Foundation gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present study are available upon reasonable request to the authors