Spinal Residents - Need your input!

[BMEGradStudent]

Hi all,

 

I'm a MSc student at the UofC in Biomedical Engineering. My thesis is focusing on developing a training tool for spinal surgeons, and seeing as how I got my Bachelor's in Mechanical Engineering, I have little to no experience with what residents go through, I really need/want/require input from spinal surgeons of all levels so that I know that I'm going in the right direction. I'd hate to develop this and find no one wants it, friggin pointless then!

 

So what I'm making has two main parts: 1) a vertebrae that will mimic both the material properties as well as the geometry of real bone, which to my knowledge doesn't exist and 2) a bone probe that can predict the breach of the cortical bone when cannulating a pedicle (mostly as a training device, to help the resident get the feel of it).

 

I would love to have honest opinions about this - especially if you don't think that this wouldn't be useful.

 

Also, I've been told that resident weekly hours have been capped, does this actually present a problem to learning enough? Do you think that effective training tools will become more valuable in the shorter allowed hours (so that you don't have to open up a cadaver to practice each time)?

 

Thanks for your input!

 

Cheers!

[coastalslacker]

Orthopaedic surgeons and neurosurgeons operate on the spine. There are no "spinal residents".

 

The bone probe you describe already exists. I saw it used in the states a couple years ago. I don't know who makes it. It beeps when you're about the breach the pedicle. It's annoying, but the guy who used it liked it because he got audible feedback on where the resident/fellow was. Also commonly used now is navigated surgery - pre-op CT, infrared sensors on your instruments, you watch as you drive yourself across the pedicle. I don't know if the scoli guys in Calgary do this, but I've heard they do in Edmonton.

 

The geometry of a vertebral body is easy to recreate - you just get a CT and use an ABS printer to print out a 3D model. This is what they do at my center at least (for studies that sound similar to what you're doing, but were done to confirm the accuracy of navigated surgery, not for educational research ). Obviously creating a model that mimics not only the shape but the mechanical properties would be great, but the reality is that there is huge variability in the feel of the pedicle from patient to patient (or level to level). Some are soft as butter and some are hard as a rock (which can be nerve wracking because you think you must be in cortex and about to pop out somewhere you shouldn't).

 

Surgical simulation is all the rage right now for two reasons: 1)despite the fact that surgical training has always been learn as you go, it makes intuitive sense that you should demonstrate the ability to perform some of the tasks in a controlled setting before you do it on a patient, and, (2) work hour restrictions are limiting exposure. I think the work hour restrictions are over-blown, frankly. My early years of residency were spent under the old regime and I didn't learn a heck of alot from being up for 40 hours straight or doing a case half asleep.... Anyways, the old guys are convinced they learned more by being exhausted all the time..... This mentality will be gone within a generation.