Abstract:

This paper revisits a case study in 2020 of a 78 year old female patient that had two compression fractures at the L1 and T12 vertebrae and had the corresponding kyphoplasties to repair the fractures. Two years later the patient developed an unrelated condition that required a CT (computed tomography) scan. As a result, it was possible for nursing students to observe the growth of bone spurs around L1 and T12. Osteophytes, or bone spurs, are calcium deposits found on the bone, particularly on or around joints. When the body thinks a bone is damaged (such as the kyphoplasty repairs in this study) the body will try to repair the bone by adding bone to the damaged area. The following approaches were taken to convert the CT scan from DICOM (digital imaging and communications in medicine) format to STL (stereolithography) format: 1) Democratiz3D software from Embodi3D.com to automatically and quickly create the STL file of the body and 2) 3DSlicer to create and segment a STL file of only the L2, L1, T12 and T11 vertebrae. 3DBuilder was used by nursing students to display the STL files on the screen and to rotate and enlarge the 3D models for analysis and student training. Several 3D printed models were made of the vertebrae near the bone spurs. Four large bone spurs were visible, covering an area of 30mm in length, 15mm in width and 15mm height at one of the peaks. Simulation based learning experiences (SBLEs) are an array of structured activities that represent actual or potential situations in education and practice. These activities allow participants to develop or enhance their knowledge, skills, and attitudes, or to analyze and respond to realistic situations in a simulated environment. SBLEs occur in a simulation laboratory where nursing students come for a given amount of time to engage in activities specifically designed around a set of learning objectives. These activities are developed into simulation cases with realistic patient scenarios. The College of Nursing has developed over one hundred SBLEs. Each simulated clinical experience is documented in detail and placed in a binder with specific objectives, a detailed set up sheet and pictures for standardized repetition with multiple clinical groups.

This case study is currently being integrated into the SBLEs and provides an opportunity for nursing students to study in general human anatomy and specifically:
1) compression fractures,
2) kyphoplasties, and
3) bone spurs developing over time from kyphoplasties.

The students, through the 3Dbuilder computer simulation software, view models of the fractures, kyphoplasty repairs and bone spurs. In addition, the corresponding 3D printed models allow the students to touch and feel the models. The Systems Management and Production Center has placed the STL files on its web based MED-NET (Model Exchange and Development of Nursing and Engineering Technologies) for nursing students to either view or download with 3DBuilder on their own computers. In these learning experiences students can rotate and enlarge a model without the need of a 3D printed model. The combination of visual and tactile feedback is a valuable learning tool. 3D printed models can provide procedural competency which is typically gained through repeated exposure.

Keywords:

Vertebra Fractures, Kyphoplastics Repair, Education and Practice, Simulation based Learning Experiences, 3D Printed Model.