Synthetic vertebrae provide authentic haptics during vertebral augmentation training

  • Marianne Hollensteiner (Speaker)

Activity: Talk or presentationOral presentation


Vertebral augmentation techniques are used to stabilize fractured vertebrae. To minimize intraoperative risks, a solid education of surgeons is desirable. To improve education of surgeons, the development of a novel hybrid patient simulator was initiated offering a realistic training setting with a physical patient phantom, which also carries synthetic vertebrae. The synthetic bones should realistically mimic the haptics of all procedural steps of cement augmentation. The aim of this study was to provide vertebrae with realistic haptics for this simulator. Therefore, synthetic vertebrae simulating the haptic feedback of all procedural steps of spinal augmentation were validated. Customized polyurethane-based vertebrae were tested and validated with reference to human vertebrae. The synthetic vertebrae had a two layered structure imitating the cortical shell and the open-celled cancellous bone. To validate the new synthetic vertebrae, transpedicular tool insertion forces, balloon tamp dilation pressure and bone cement distribution were analyzed. The radiopaque synthetic vertebrae were able to reflect the characteristic haptic parameters in comparison to the human reference. The characteristic shape of the force-measurementcurve, consisting of two distinctive peaks caused by penetration forces of the cortical bone due to the shape of the needle and linearly increasing, fluctuating friction forces of the cancellous bone, were clearly reproduced by the artificial bones (maximum cortical penetration forces of human: 29.1-147.6N, synthetic: 20.9-151.6N). The balloon dilation pressures (9.1-14.5bar) and volumes (2.6-6.9ml) of the customized vertebrae were in good accordance with the human reference (5.4-15.8bar, 2.1-6.3ml). Although the cement application forces fitted well either, the analyzed cement distribution could not be reproduced accurately due to absent fracture in the tested vertebrae. Our findings demonstrate that our model of synthetic vertebrae provide realistic haptic feedback for vertebral augmentation training. The validated vertebra model will be used within a hybrid simulator for minimally invasive spine surgery to educate and train surgeons.
Period29 Nov 2018
Event titleISFR
Event typeConference
LocationKyoto, JapanShow on map