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.

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.

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.