Three-dimensional printing models improve understanding of spinal fracture—A randomized controlled study in China

Abstract

Three-dimensional printing (3Dp) is being increasingly used in medical education. Although the use of such lifelike models is beneficial, well-powered, randomized studies supporting this statement are scarce. Two spinal fracture simulation models were generated by 3Dp. Altogether, 120 medical students (54.2% females) were randomized into three teaching module groups [two-dimensional computed tomography images (CT), 3D, or 3Dp] and asked to answer 10 key anatomical and 4 evaluative questions. Students in the 3Dp or 3D group performed significantly better than those in the CT group, although males in the 3D group scored higher than females. Students in the 3Dp group were the first to answer all questions, and there were no sex-related differences. Pleasure, assistance, effect, and confidence were more predominant in students in the 3Dp group than in those in the 3D and CT groups. This randomized study revealed that the 3Dp model markedly improved the identification of complex spinal fracture anatomy by medical students and was equally appreciated and comprehended by both sexes. Therefore, the lifelike fracture model made by 3Dp technology should be used as a means of premedical education.

The role of 3D printing in anatomy education and surgical training: A narrative review

“…The two 3D groups achieved a statistically significant higher postexposure score than the '2D' anatomical atlas group, both in the immediate assessment and a 'surprise' test 5-days later. Another study echoed this finding (Li et al, 2015). 2D CT images, monochromatic 3Dv and monochromatic 3Dp models were used to deliver teaching with respect to cervical and thoracic spinal anatomy and fractures.…”

“…3D models in any form are preferred over 2D images (Hoyek et al, 2014;Li et al, 2015). This impact is greater in 3Dp models compared to 3Dv models (Li et al, 2015), with students reporting greater pleasure, personal learning effect and confidence in explaining to peers. 3Dp and cadaveric skulls were allocated strongly positive ratings by over 85% of the students in the categories of enjoyment, intention to use, attitude and learning efficiency .…”

Multiple Software Based 3D Modeling Protocol for Printing Anatomical Structures

“…As the gray level of the pixels in DICOM files is determined by the density of the tissue, the segmentation was implemented by thresholding. This technique allows to establish a range of gray levels in the image and select the desired ones (Jacobs et al, 2008;Li et al). According to this, to select aortic arteries, the designated threshold doesn't include gray levels corresponding to bones, epithelial tissue or fat tissue.…”

“…InVesalius allows to export the 3D surface in different formats. Generally, the desired format for rapid prototyping is a stereolithography file (STL) (Li et al 2015), so each surface was exported as an STL. This STL contains a surface composed of triangles and squares arrangements, these polygons are in charge of shaping the surface (Fig.…”

“…3D printing is based in the construction layer by layer of a physical structure that represents a virtual model (Li et al, 2015). This process has demonstrated to be cost-effective and highly accurate (Bagaria et al), since the structure comes from a virtual model, 3D printing allows to make almost any kind of structure.…”