1.Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey
Bilal Bahadır AKBULUT ; Elif Ezgi ÇENBERLITAŞ ; Mustafa Serdar BÖLÜK ; Taşkın YURTSEVEN ; Hüseyin BIÇEROĞLU
Asian Spine Journal 2025;19(2):183-193
Methods:
Eight neurosurgery residents each with over 2 years of training completed four training sessions on two randomly assigned cervical spine levels using the newly developed 3D-printed model. A simple plumbing endoscope was used for real-time surgical visualization.
Results:
Among the 64 completed surgical levels, left-sided procedures showed significantly higher insufficient decompression rates than did right-sided procedures (25.0% vs. 3.6%, p=0.002). However, no significant difference in overall complication rates was observed between sides (p=0.073). Surgical parameters remained consistent across sides, with no significant differences in operative duration. Brunner-Langer analysis revealed substantial improvements in operative duration (mean duration decrease from 21:42±2:15 to 6:33±0:42 minutes, p=0.004) and total complications (mean decrease from 2.1±0.8 to 0.4±0.5, p=0.007) across sessions. Although fluoroscopy timing showed marginal improvement (mean duration decrease from 2:12±1:15 to 0:55±0:23 minutes, p=0.057), the number of fluoroscopic images tended to decrease.
Conclusions
Our findings suggest that this novel 3D-printed cervical spine model could be a viable, low-cost option for neurosurgical training programs aiming to help residents develop essential endoscopic skills in a controlled setting. Facilitating early proficiency in posterior cervical foraminotomy can serve as a valuable intermediate step before transitioning to cadaveric models and clinical practice.
2.Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey
Bilal Bahadır AKBULUT ; Elif Ezgi ÇENBERLITAŞ ; Mustafa Serdar BÖLÜK ; Taşkın YURTSEVEN ; Hüseyin BIÇEROĞLU
Asian Spine Journal 2025;19(2):183-193
Methods:
Eight neurosurgery residents each with over 2 years of training completed four training sessions on two randomly assigned cervical spine levels using the newly developed 3D-printed model. A simple plumbing endoscope was used for real-time surgical visualization.
Results:
Among the 64 completed surgical levels, left-sided procedures showed significantly higher insufficient decompression rates than did right-sided procedures (25.0% vs. 3.6%, p=0.002). However, no significant difference in overall complication rates was observed between sides (p=0.073). Surgical parameters remained consistent across sides, with no significant differences in operative duration. Brunner-Langer analysis revealed substantial improvements in operative duration (mean duration decrease from 21:42±2:15 to 6:33±0:42 minutes, p=0.004) and total complications (mean decrease from 2.1±0.8 to 0.4±0.5, p=0.007) across sessions. Although fluoroscopy timing showed marginal improvement (mean duration decrease from 2:12±1:15 to 0:55±0:23 minutes, p=0.057), the number of fluoroscopic images tended to decrease.
Conclusions
Our findings suggest that this novel 3D-printed cervical spine model could be a viable, low-cost option for neurosurgical training programs aiming to help residents develop essential endoscopic skills in a controlled setting. Facilitating early proficiency in posterior cervical foraminotomy can serve as a valuable intermediate step before transitioning to cadaveric models and clinical practice.
3.Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey
Bilal Bahadır AKBULUT ; Elif Ezgi ÇENBERLITAŞ ; Mustafa Serdar BÖLÜK ; Taşkın YURTSEVEN ; Hüseyin BIÇEROĞLU
Asian Spine Journal 2025;19(2):183-193
Methods:
Eight neurosurgery residents each with over 2 years of training completed four training sessions on two randomly assigned cervical spine levels using the newly developed 3D-printed model. A simple plumbing endoscope was used for real-time surgical visualization.
Results:
Among the 64 completed surgical levels, left-sided procedures showed significantly higher insufficient decompression rates than did right-sided procedures (25.0% vs. 3.6%, p=0.002). However, no significant difference in overall complication rates was observed between sides (p=0.073). Surgical parameters remained consistent across sides, with no significant differences in operative duration. Brunner-Langer analysis revealed substantial improvements in operative duration (mean duration decrease from 21:42±2:15 to 6:33±0:42 minutes, p=0.004) and total complications (mean decrease from 2.1±0.8 to 0.4±0.5, p=0.007) across sessions. Although fluoroscopy timing showed marginal improvement (mean duration decrease from 2:12±1:15 to 0:55±0:23 minutes, p=0.057), the number of fluoroscopic images tended to decrease.
Conclusions
Our findings suggest that this novel 3D-printed cervical spine model could be a viable, low-cost option for neurosurgical training programs aiming to help residents develop essential endoscopic skills in a controlled setting. Facilitating early proficiency in posterior cervical foraminotomy can serve as a valuable intermediate step before transitioning to cadaveric models and clinical practice.
4.Evaluating the efficacy of a cost-effective, fully three-dimensional-printed vertebra model for endoscopic spine surgery training for neurosurgical residents
Bilal Bahadır AKBULUT ; Mustafa Serdar BÖLÜK ; Hüseyin BIÇEROĞLU ; Taşkın YURTSEVEN
Asian Spine Journal 2024;18(5):630-638
Methods:
Eight residents with >2 years of training participated. Residents performed the procedure bilaterally and twice at 1-week intervals.
Results:
From the 32 surgeries, four were excluded because of facet removal (as it widened the surgical corridor), leaving 28 surgeries for analysis. Initial surgeries demonstrated a mean operation time of 21 minutes 18 seconds (standard deviation [SD], 2 minutes 32 seconds), which improved to a mean of 6 minutes 45 seconds (SD, 37 seconds) in the fourth surgery (F(3, 17)=19.18, p <0.0001), demonstrating a significant reduction in surgical time over successive surgeries. The median area with the paint removed decreased, from 161.80 (85.55–217.83) to 95.13 mm2 (12.62–160.54), (F(2.072, Inf)=2.04, p =0.128); however, this was not significant. Resident feedback indicated high satisfaction with the educational value of the model.
Conclusions
The developed fully 3D-printed model provides a viable and scalable option for neurosurgical training programs, enhancing the learning experience while maintaining low costs. This model may be an excellent stepping stone for learning lumbar spine endoscopy, acclimating to the two-dimensional view, progressing to cadaver models, and, eventually, independent surgery.

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