Characterization of polyurethane-based synthetic vertebrae for spinal cement augmentation training
| Autor: | Stefan Gabauer, Peter Augat, Melanie Botzenmayer, David Fürst, Sabrina Sandriesser, Falk Schrödl, Martin Winkler, Marianne Hollensteiner, Klaus Püschel, Benjamin Esterer, Andreas Schrempf |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
musculoskeletal diseases medicine.medical_specialty Materials science Polyurethanes Biomedical Engineering Biophysics Bioengineering Balloon Injections Biomaterials 03 medical and health sciences 0302 clinical medicine medicine Fluoroscopy Humans Minimally Invasive Surgical Procedures Cement augmentation Kyphoplasty Lumbar Vertebrae medicine.diagnostic_test Bone Cements Bone cement musculoskeletal system Surgical training Vertebra Biomechanical Phenomena medicine.anatomical_structure Clinical Applications of Biomaterials Needles Orthopedic surgery Bone Substitutes Balloon dilation Spinal Fractures Female 030101 anatomy & morphology 030217 neurology & neurosurgery Biomedical engineering |
| Zdroj: | Journal of Materials Science. Materials in Medicine |
| ISSN: | 1573-4838 0957-4530 |
| Popis: | 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. Highlights Anatomically realistic open-celled vertebrae based on polyurethane and calcium-based mineral fillers were developed.Spine surgery specific testing of human and synthetic vertebrae were conducted.The examined tool insertion forces and balloon tamp dilation pressures of artificial vertebrae were highly comparable to human ones.Open-celled artificial vertebrae enabled a realistic bone cement distribution.Realistic haptic performance and behavior of two composite materials confirmed their suitability for training in the field of spine surgery. |
| Databáze: | OpenAIRE |
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