Department of Neurological Surgery, Mayo Clinic Florida, Jacksonville, Florida, USA.
Florida State University College of Medicine, Tallahassee, Florida, USA.
Clin Anat. 2021 Jan;34(1):30-39. doi: 10.1002/ca.23607. Epub 2020 May 5.
Three-dimensional (3D) printing of anatomical structures is a growing method of education for students and medical trainees. These models are generally produced as static representations of gross surface anatomy. In order to create a model that provides educators with a tool for demonstration of kinematic and physiologic concepts in addition to surface anatomy, a high-resolution segmentation and 3D-printingtechnique was investigated for the creation of a dynamic educational model.
An anonymized computed tomography scan of the cervical spine with a diagnosis of ossification of the posterior longitudinal ligament was acquired. Using a high-resolution thresholding technique, the individual facet and intervertebral spaces were separated, and models of the C3-7 vertebrae were 3D-printed. The models were placed on a myelography simulator and subjected to flexion and extension under fluoroscopy, and measurements of the spinal canal diameter were recorded and compared to in-vivo measurements. The flexible 3D-printed model was then compared to a static 3D-printed model to determine the educational benefit of demonstrating physiologic concepts.
The canal diameter changes on the flexible 3D-printed model accurately reflected in-vivo measurements during dynamic positioning. The flexible model also was also more successful in teaching the physiologic concepts of spinal canal changes during flexion and extension than the static 3D-printed model to a cohort of learners.
Dynamic 3D-printed models can provide educators with a cost-effective and novel educational tool for not just instruction of surface anatomy, but also physiologic concepts through 3D ex-vivo modeling of case-specific physiologic and pathologic conditions.
三维（3D）打印解剖结构是学生和医学实习生教育的一种不断发展的方法。这些模型通常作为大体表面解剖的静态表示来制作。为了创建一个不仅可以提供表面解剖学教学，还可以通过特定病例的生理和病理情况的 3D 体外模型来演示运动学和生理学概念的模型，研究了一种高分辨率的分割和 3D 打印技术。
获取颈椎后纵韧带骨化的颈椎 CT 扫描。使用高分辨率的阈值技术，将各个关节突和椎间空间分开，并对 C3-7 椎体进行 3D 打印。将模型放置在脊髓造影模拟器上，在透视下进行屈伸运动，并记录椎管直径的测量值并与体内测量值进行比较。然后将柔性 3D 打印模型与静态 3D 打印模型进行比较，以确定演示生理概念的教育收益。
在动态定位过程中，柔性 3D 打印模型上的椎管直径变化准确反映了体内测量值。与静态 3D 打印模型相比，柔性模型在向学习者群体教授椎管在屈伸过程中变化的生理概念方面也更成功。
动态 3D 打印模型可以为教育工作者提供一种具有成本效益的新颖教育工具，不仅可以用于指导表面解剖学，还可以通过特定病例的生理和病理情况的 3D 体外模型来演示运动学和生理学概念。
