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. 2025 Mar 27;17(3):e81297.
doi: 10.7759/cureus.81297. eCollection 2025 Mar.

Realistic 3D-Printed Lumbar Spine Model for Non-cadaveric Surgical Training: A Proof of Concept Study

Todor G Bogdanov  1 , Hristo R Tsonev  2 , Dimo A Yankov  2 , Rene D Mileva-Popova  3 , Dilyan Ferdinandov  2   4
Affiliations

Realistic 3D-Printed Lumbar Spine Model for Non-cadaveric Surgical Training: A Proof of Concept Study

Todor G Bogdanov et al. Cureus. .

Abstract

Surgical simulation plays a crucial role in modern neurosurgical training, allowing surgeons to develop and refine their skills in a controlled and risk-free environment. Traditional methods, such as cadaveric dissections, and virtual reality (VR) simulations more recently have their advantages and limitations. While cadaveric models offer high anatomical accuracy, they are expensive, difficult to access, and non-reusable. VR simulations provide customizable training experiences but lack the realistic haptic feedback necessary for hands-on procedures. With advancements in 3D printing technology, anatomically accurate and cost-effective physical models have emerged as a viable alternative for surgical training. This study aims to develop and validate a realistic 3D-printed lumbar spine model for non-cadaveric surgical education. The proposed model replicates the anatomical and biomechanical properties of the L1-S1 segment and is produced using fused deposition modeling (FDM) 3D printing technology with polylactic acid (PLA) vertebrae, PolyFlex TPU95 intervertebral discs, and an elastic TPU (thermoplastic polyurethane) rod to mimic physiological movement. The model is based on DICOM imaging data from a CT scan of a patient's spine, optimized for biomechanical resistance and realistic pedicle screw placement training. It was tested in hands-on neurosurgical workshops at St. Ivan Rilski University Hospital in Sofia. Post-training X-ray analysis confirmed the accuracy of screw positioning and the anatomical fidelity of the model. The results demonstrate that this 3D-printed lumbar spine model provides an accessible, customizable, and reliable training tool for spine surgery. Future improvements may include multi-material printing, augmented reality (AR) integration, and adaptations for pathological conditions.

Keywords: 3d-printed spine model; cost-effective physical models; educational model; lumbar spine; non-cadaveric surgical training.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Commission on Scientific Research Ethics, Medical University of Sofia issued approval VK-416-26/12.03.2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This research is financially supported by Medical University of Sofia under Contract D-163/29.05.2024 for the Funding of Scientific Research in the 2024 Grant Competition. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Vertebrae position (A), L1-S1 spinal segment with artificially reconstructed intervertebral discs (B), and the final 3D printed version on the holder (C)
Figure 2
Figure 2. Grid (A and B) and gyroid (C) infill patterns at 15% densities
Figure 3
Figure 3. Stages of training: initial hole drilling (A), screw insertion (B), and final positioning of the screws (C)
Figure 4
Figure 4. X-ray images of models with implanted screws, assessed for accuracy
See this image and copyright information in PMC

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