Surgical treatment interventions for low-back pain are increasing. Surgical risk associated with new techniques can be reduced by practice on synthetic spine replicas. However, current models for surgical training on intervertebral disk procedures do not represent average patients because they exhibit variable degrees of degeneration. A low-cost synthetic intervertebral disk device with lifelike sensory and visual feedback to enhance surgeon training was developed. Design criteria for the synthetic analog intervertebral disks (IVDs) were based on observations of fresh frozen human cadaveric disks, surgeon input, and literature descriptions; prototypes were designed to mimic a Grade I-II lumbar IVD. Qualitative evaluation was done by interviewing orthopedic surgeons during mock surgeries on the model. The surgical feel was quantitatively evaluated by a mock nucleotomy on prototypes and cadaveric specimens using instrumented surgical tools. In qualitative analysis, two orthopedic surgeons commented that the visual and tactile qualities of the model were similar to disks of adult spine surgery patients. Quantitative test results showed similarities between human and analog disks. The inexpensive synthetic IVD design successfully replicated the main features of a human cadaveric disk.

1.
National Neurosurgical Statistics, 1999 Procedural Statistics, American Association of Neurological Surgeons Web site, 2003, available at http://www.aans.orghttp://www.aans.org, accessed Nov. 14, 2003.
2.
Österman
,
H.
,
Sund
,
R.
,
Seitsalo
,
S.
, and
Keskimäki
,
I.
, 2003, “
Risk of Multiple Reoperations After Lumbar Discectomy: A Population Based Study
,”
Spine
0362-2436,
28
(
6
), pp.
621
627
.
3.
Orrico
,
K.
, and
Monroe
,
H.
, 2003, “
New Study Finds Medical Liability Crisis for Neurosurgeons Worsening—Patients Are Losing Access to Neurosurgical Care
,” available at http://www.neurosurgery.org/health/news/detail.asp?PressID=191http://www.neurosurgery.org/health/news/detail.asp?PressID=191, accessed Nov. 14, 2003.
4.
Svoboda
,
C.
, 1998, “
Model Patient, Model Tutor. Do Medical Students Still Need to Practice on Live Patients?
,” Student BMJ Education Web site, available at http://www.studentbmj.com/back_issues/1098/data/1098ed2.htmhttp://www.studentbmj.com/back_issues/1098/data/1098ed2.htm, accessed Nov. 14, 2003.
5.
Grignon
,
B.
,
Gross
,
S.
,
Roland
,
J.
, and
Braun
,
M.
, 1994, “
Le Disque Intervertebral Lombaire. Structure. Etat Des Connaissances
,”
Bull. Assoc. Anat. (Nancy)
0376-6160,
78
(
243
), pp.
49
52
.
6.
Grignon
,
B.
,
Gross
,
S.
,
Roland
,
J.
, and
Braun
,
M.
, 1994, “
Le Disque Intervertebral Lombaire. Voies De Passage Disque Intervertebral-Corps Vertebral Et Vascularisation Discale
,”
Group Organiz. Stud.
0364-1082,
78
(
243
), pp.
43
57
.
7.
Marchand
,
F.
, and
Ahmed
,
A. M.
, 1990, “
Investigation of the Laminate Structure of Lumbar Disc Annulus Fibrosus
,”
Spine
0362-2436,
15
(
5
), pp.
402
410
.
8.
Cassidy
,
J. J.
,
Hiltner
,
A.
, and
Baer
,
E.
, 1989, “
Hierarchical Structure of the Intervertebral Disc
,”
Connect. Tissue Res.
0300-8207,
23
, pp.
75
88
.
9.
Roberts
,
S.
, 2002, “
Disc Morphology in Health and Disease
,” Biochemical Society Transactions, Online Transactions,
30
(
6
), available at http://www.biochemsoctrans.org/bst/030/0864/0300864.pdfhttp://www.biochemsoctrans.org/bst/030/0864/0300864.pdf, accessed Nov. 14, 2003.
10.
Moore
,
R. J.
, 2000, “
The Vertebral End-Plate: What Do We Know?
,”
Eur. Spine J.
0940-6719,
9
(
2
), pp.
92
96
.
11.
Schmorl
,
G.
, and
Junghanns
,
H.
, 1971,
The Human Spine in Health and Disease
,
2nd American ed.
,
Grune and Stratton
,
New York
.
12.
Parke
,
W. W.
, and
Schiff
,
D. C.
, 1971, “
The Applied Anatomy of the Intervertebral Disc
,”
Orthop. Clin. North Am.
0030-5898,
2
(
2
), pp.
309
324
.
13.
Markolf
,
K. L.
, and
Morris
,
J. M.
, 1974, “
The Structural Components of the Intervertebral Disc. A Study of Their Contributions to the Ability of the Disc to Withstand Compressive Forces
,”
J. Bone Jt. Surg., Am. Vol.
0021-9355,
56A
(
4
), pp.
675
687
.
14.
Eijkelkamp
,
M. F.
,
Van Donkelaar
,
C. C.
,
Veldhuizen
,
A. G.
,
Van Horn
,
J. R.
,
Huyghe
,
J. M. R. J.
, and
Verkerke
,
G. J.
, 2001, “
Requirements for an Artificial Intervertebral Disc
,”
Int. J. Artif. Organs
0391-3988,
24
(
5
), pp.
311
321
.
15.
Jensen
,
G. M.
, 1980, “
Biomechanics of the Lumbar Intervertebral Disk: A Review
,”
Phys. Ther.
0031-9023,
60
(
6
), pp.
765
773
.
16.
Hadjipavlou
,
A. G.
,
Simmons
,
J. W.
,
Pope
,
M. H.
,
Necessary
,
J. T.
, and
Guel
,
V. K.
, 1999, “
Pathomechanics and Clinical Relevance of Disc Degeneration and Annular Tear: A Point-of-View Review
,”
Am. J. Orthop.
0065-9002,
28
, pp.
561
571
.
17.
Ambrosio
,
L.
,
De Santis
,
R.
, and
Nicolais
,
L.
, 1998, “
Composite Hydrogels for Implants
,”
Proc. Inst. Mech. Eng., Part H: J. Eng. Med.
0954-4119,
212
(
2
), pp.
93
100
.
18.
Hron
,
P.
,
Slechtova
,
J.
,
Smetana
,
K.
,
Dvorankova
,
B.
, and
Lopour
,
P.
, 1997, “
Silicone Rubber-Hydrogel Composites as Polymeric Biomaterials. IX. Composites Containing Powdery Polyacrylamide Hydrogel
,”
Biomaterials
0142-9612,
18
(
15
), pp.
1069
1073
.
19.
White
,
A. A.
, and
Panjabi
,
M. M.
, 1990,
Clinical Biomechanics of the Spine
,
2nd ed.
,
Lippincott-Raven
,
Philadelphia
.
20.
Normal Power Calculations, Normal Distribution 2-Sample Unequal Variances, available at http://calculators.stat.ucla.edu/powercalc/normal/n-2-nequal/index.phphttp://calculators.stat.ucla.edu/powercalc/normal/n-2-nequal/index.php, accessed May 5, 2006.
21.
Adams
,
M.
,
Bogduk
,
N.
,
Burton
,
K.
, and
Dolan
,
P.
, 2002,
The Biomechanics of Pain
,
Churchill Livingstone
,
New York
.
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