Artificial Vertebrae for a Novel Simulator in Minimally Invasive Spine Surgery

Hollensteiner, Marianne; Fuerst, David; Schrempf, Andreas

doi:10.1515/bmt-2013-4409

Cited by 10 publications

(8 citation statements)

References 7 publications

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“…Commercially available bones do not deliver realistic haptic feedback during orthopedic interventions [12][13][14]. In addition, a surgical simulator for the training of parietal graft lifts is currently not available and therefore it is apparent that sufficient artificial bones would be beneficial for surgical training.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies show that these PU models match in mechanical properties with human bones [10,11]. However investigations dealing with orthopedic applications on these PU based models show controverse results [12][13][14]. The goal of this investigation was the development of parietal bone surrogates which are validated for drilling, milling and sawing.…”

Section: Introductionmentioning

confidence: 99%

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Development of parietal bone surrogates for parietal graft lift training

Hollensteiner

Fürst

Esterer

et al. 2016

Current Directions in Biomedical Engineering

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Abstract:Currently the surgical training of parietal bone graft techniques is performed on patients or specimens. Commercially available bone models do not deliver realistic haptic feedback. Thus customized parietal skull surrogates were developed for surgical training purposes. Two human parietal bones were used as reference. Based on the measurement of insertion forces of drilling, milling and saw procedures suitable material compositions for molding cortical and cancellous calvarial layers were found. Artificial skull caps were manufactured and tested. Additionally microtomograpy images of human and artificial parietal bones were performed to analyze outer table and diploe thicknesses. Significant differences between human and artificial skulls were not detected with the mechanical procedures tested. Highly significant differences were found for the diploe thickness values. In conclusion, an artificial bone has been created, mimicking the properties of human parietal bone thus being suitable for tabula externa graft lift training.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of parietal bone surrogates for parietal graft lift training

Hollensteiner

Fürst

Esterer

et al. 2016

Current Directions in Biomedical Engineering

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“…The needle force F n (t) is composed by cutting and clamping forces (see [10] for bone tissue) and is modeled by…”

Section: Parametrical Model For Needle Insertionmentioning

confidence: 99%

“…Integral parts of this simulator are these synthetic tissues, which should generate a high fidelity haptic feedback for surgical needle insertion and therefore should have assimilable mechanical properties to natural tissues. Suitable artificial vertebrae were already developed and validated [9], [10]. The aim of this study was to find materials which provide a feedback comparable to natural muscles and skin.…”

Section: Introductionmentioning

confidence: 99%

Artificial muscles for a novel simulator in minimally invasive spine surgery

Hollensteiner¹,

Fuerst

Schrempf³

2014

2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Vertebroplasty and kyphoplasty are commonly used minimally invasive methods to treat vertebral compression fractures. Novice surgeons gather surgical skills in different ways, mainly by "learning by doing" or training on models, specimens or simulators. Currently, a new training modality, an augmented reality simulator for minimally invasive spine surgeries, is going to be developed. An important step in investigating this simulator is the accurate establishment of artificial tissues. Especially vertebrae and muscles, reproducing a comparable haptical feedback during tool insertion, are necessary. Two artificial tissues were developed to imitate natural muscle tissue. The axial insertion force was used as validation parameter. It appropriates the mechanical properties of artificial and natural muscles. Validation was performed on insertion measurement data from fifteen artificial muscle tissues compared to human muscles measurement data. Based on the resulting forces during needle insertion into human muscles, a suitable material composition for manufacturing artificial muscles was found.

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“…The simulator consists of a realistic patient phantom and a fluoroscopy simulation. The patient-phantom composed of validated synthetic vertebrae [ 17 ] and soft tissues [ 18 ], allows a realistic transpedicular bone access. The synthetic vertebrae consist of an outer rigid shell mimicking the cortical layer and closed-cell polyurethane foam imitating the trabecular structure [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Characterization of polyurethane-based synthetic vertebrae for spinal cement augmentation training

Hollensteiner

Botzenmayer

Fürst³

et al. 2018

J Mater Sci: Mater Med

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Vertebral augmentation techniques are used to stabilize impacted vertebrae. To minimize intraoperative risks, a solid education of surgeons is desirable. Thus, to improve education of surgeons as well as patient safety, the development of a high-fidelity simulator for the surgical training of cement augmentation techniques was initiated. The integrated synthetic vertebrae should be able to provide realistic haptics during all procedural steps. Synthetic vertebrae were developed, tested and validated with reference to human vertebrae. As a further reference, commercially available vertebrae surrogates for orthopedic testing were investigated. To validate the new synthetic vertebrae, characteristic mechanical parameters for tool insertion, balloon dilation pressure and volume were analyzed. Fluoroscopy images were taken to evaluate the bone cement distribution. Based on the measurement results, one type of synthetic vertebrae was able to reflect the characteristic parameters in comparison to human vertebrae. The different tool insertion forces (19.7 ± 4.1, 13.1 ± 0.9 N, 1.5 ± 0.2 N) of the human reference were reflected by one bone surrogate (11.9 ± 9.8, 24.3 ± 3.9 N, 2.4 ± 1.0 N, respectively). The balloon dilation pressure (13.0 ± 2.4 bar), volume (2.3 ± 1.5 ml) of the synthetic vertebrae were in good accordance with the human reference (10.7 ± 3.4 bar, 3.1 ± 1.1 ml). Cement application forces were also in good accordance whereas the cement distribution couldn’t be reproduced accurately. Synthetic vertebrae were developed that delivered authentic haptics during transpedicular instrument insertion, balloon tamp dilation and bone cement application. The validated vertebra model will be used within a hybrid simulator for minimally invasive spine surgery to educate and train surgeons.

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Artificial Vertebrae for a Novel Simulator in Minimally Invasive Spine Surgery

Cited by 10 publications

References 7 publications

Development of parietal bone surrogates for parietal graft lift training

Development of parietal bone surrogates for parietal graft lift training

Artificial muscles for a novel simulator in minimally invasive spine surgery

Characterization of polyurethane-based synthetic vertebrae for spinal cement augmentation training

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