Abstract:

This paper investigated the use of 3D computer simulations that were created by 3Dslicer and 3Dbuilder and the use of 3D printed models in studying and analyzing the compression fractures at L1 and T12 vertebrae and the kyphoplasty procedure to repair the compression fracture at L1. No MRI was available to study the results of the kypoplasty repair to T12. The MRIs were obtained from a patient that had suffered compression fractures at L1 and T12. The first MRI1 showed the compression fracture at L1. The radiologist report stated that the patient had suffered a 75% vertical height loss of L1. Consequently, the fracture was easily to see on the MRI. Shortly thereafter the patient suffered a compression fracture at T12. The radiologist reported that the patient had suffered a 20% vertical height loss of T12. Consequently, it was more difficulty to see the T12 compression fracture on MRI2. MRI2 also showed the kyphoplasty repair to L1. The MRIs were focused on enhancing the compression fractures and consequently the vertebral body. As a result, the spatial resolution was too coarse to resolve the other structures of the vertebrae. Therefore, the 3Dslicer and 3Dbuilder simulation models and the 3D printed models only included the vertebral body. Most 3D printed models of the spine are made from CT scans and not MRIs. In a CT the spatial resolution is usually higher than a MRI. Also the pixel values in a CT are quantitative. Therefore, the higher spatial resolution along with specific pixel ranges make CT images easier to segment, and consequently 3D print, than an MIR image, where tissues can only be segmented by contrast in intensities. Of special interest in this paper was the visualization of the distribution of the cement that was injected into L1 during the kyphoplasty repair. The 3Dslicer graphically illustrated the compression fractures and the distribution of the cement in the L1 compression fracture. The 3Dbuilder allowed for the rotation and enlargement of the compression fractures and for the location of the bone cement in the L1 fracture. Color was added to the models to better visualize the compression fractures and the kyphoplasty repair. Multiple views of the compression fractures are critical in studying various features and especially the results of the kyphoplasties. 3Dbuilder simulations of the fractures were just as valuable as the actual 3D printed model is studying the various features. The use of color in the 3Dslicer and 3Dbuilder simulations is an excellent tool for better visualization and for evaluating the flow of the bone cement at L1. Segmenting details are critical to improve the viewing of the compression fractures and the flow of the kyphoplasty cement in the compression fracture at L1. Some estimation was necessary when using the 3Dslicer software in tracing the distribution of the cement in L1. These estimations can greatly affect the accuracy of the final 3D printed model. The 3Dbuilder computer simulations are being stored in the College of Nursing’s (CoN) MEDNET website. Nursing students can visit the website at any time for study and analysis. Included in this paper are a description of the spine segments; the compression fractures; 3Dslicer and 3Dbuilder computer simulations; the 3D printed models; the use of the simulations and 3D printed models in the simulation based learning experiences in the CoN at the Alabama in Huntsville and conclusions.

Keywords:

3D computer simulation, 3D slider, 3D bilder, analyzing compression fractures, CT images, kyphoplasty repair, simulation based learning experiences.