The Living Spine Model: A Biomimetic Surgical Training and Education Tool

BACKGROUND: The Living Spine Model (LSM) is a three-dimensionally printed, surgical training platform developed by neurosurgical residents. OBJECTIVE: To evaluate the face and content validity of this model as a training tool for open posterior lumbar surgery. METHODS: Six surgeons with varying experience were asked to complete L3-5 pedicle screw fixation and 13-4 laminectomy on an LSM. Face validity was measured using a questionnaire, and content validity was measured using the National Aeronautics and Space Administration Task Load Index (NASA TLX) tests. Student's t-test was used to compare NASA TLX responses between junior and senior residents and to compare responses for live surgery vs simulated surgery on the LSM. RESULTS: Junior residents took the longest time to complete the procedure, followed by senior residents and the attending surgeon (136.5, 98.3, and 84 min, respectively). The junior residents placed fewer successful pedicle screws (7/12) than senior residents and attending surgeon (18/18). All tested components of the model had excellent face validity, with scores ranging from 60% to 97%. Content validity testing demonstrated that the LSMs created overall workloads and specific types of work like live operating conditions. CONCLUSION: The overall validity testing of the LSM demonstrates the high-potential utility of this model as a surgical education and testing platform for open posterior lumbar procedures. The LSM has great potential as an adjunct to surgical education, and it may become an increasingly important component of surgical resident curricula in the future.