Personalized Biomodel of the Cervical Spine for Laboratory Laminoplasty Training.

OBJECTIVE: The use of biomodels in the laboratory for studying and training cervical laminoplasty has not yet been reported. We propose the use of a cervical spine biomodel for surgical laminoplasty training. METHODS: This is an experimental study. Ten 3D identical cervical spine biomodels were printed based on computed tomography (CT) and magnetic resonance imaging scans of a patient diagnosed with spondylotic cervical myelopathy. The additive manufacturing method used fused deposition modeling and polylactic acid (PLA) was selected as the raw material. The sample was divided into 2 groups: control (n = 5; the biomodels were submitted to CT scanning) and open-door (n = 5; the biomodels were submitted to open-door laminoplasty and postoperative CT). The area and anteroposterior diameter of the vertebral canal were measured on CT scans. RESULTS: Printing each piece took 12 hours. During the surgical procedure, there was sufficient support from the biomodels to keep them immobilized. Using the drill was feasible; however continuous irrigation was mandatory to prevent plastic material overheating. The raw material made the biomodel CT study possible. The vertebral canal dimensions increased 24.80% (0.62 cm2) in area and 24.88% (3.12 mm) in anteroposterior diameter CONCLUSIONS: The cervical spine biomodels can be used for laminoplasty training, even by using thermosensitive material such as PLA. The use of continuous irrigation is essential while drilling.

Improvement of optic nerve pial blood supply visualized through indocyanine green videoangiography after resection of a tuberculum sellae meningioma: 2-dimensional operative video.

Ischemia of the optic nerve (ON) is an important cause of visual field deficit provoked by tuberculum sellae (TS) meningiomas. Indocyanine green (ICG) videoangiography could provide prognostic information. Moreover, it allows new insight into the pathophysiology of visual disturbance. The authors present the case of a 48-year-old woman with visual field impairment. Magnetic resonance imaging (MRI) depicted a lesion highly suggestive of a TS meningioma. Following microsurgical resection, ICG videoangiography demonstrated improvement of right ON pial blood supply. In this case, there was one lesion causing visual impairment through both direct compression over the left ON and ischemia to the right nerve. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21155.