Simulated spinal cerebrospinal fluid leak repair: an educational model with didactic and technical components.

Authors

George M. Ghobrial, MD, Thomas Jefferson UniversityFollow
Paul A Anderson, University of Wisconsin, Madison, WIFollow
Rohan Chitale, MD, Thomas Jefferson UniversityFollow
Peter Campbell, MD, Thomas Jefferson UniversityFollow
Darlene A Lobel, MD, Thomas Jefferson UniversityFollow
James Harrop, MD, Rothman Institute, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

10-1-2013

Comments

This article has been peer reviewed. It is the authors' final version prior to publication in Neurosurgery.

Volume 73, October 23, 2013, Pages 111-115.

The published version is available at DOI: 10.1227/NEU.0000000000000100. Copyright © Lippincott, Williams and Wilkins.

Abstract

BACKGROUND: In the era of surgical resident work hour restrictions, the traditional apprenticeship model may provide fewer hours for neurosurgical residents to hone technical skills. Spinal dura mater closure or repair is 1 skill that is infrequently encountered, and persistent cerebrospinal fluid leaks are a potential morbidity.

OBJECTIVE: To establish an educational curriculum to train residents in spinal dura mater closure with a novel durotomy repair model.

METHODS: The Congress of Neurological Surgeons has developed a simulation-based model for durotomy closure with the ongoing efforts of their simulation educational committee. The core curriculum consists of didactic training materials and a technical simulation model of dural repair for the lumbar spine.

RESULTS: Didactic pretest scores ranged from 4/11 (36%) to 10/11 (91%). Posttest scores ranged from 8/11 (73%) to 11/11 (100%). Overall, didactic improvements were demonstrated by all participants, with a mean improvement between pre- and posttest scores of 1.17 (18.5%; P = .02). The technical component consisted of 11 durotomy closures by 6 participants, where 4 participants performed multiple durotomies. Mean time to closure of the durotomy ranged from 490 to 546 seconds in the first and second closures, respectively (P = .66), whereby the median leak rate improved from 14 to 7 (P = .34). There were also demonstrative technical improvements by all.

CONCLUSION: Simulated spinal dura mater repair appears to be a potentially valuable tool in the education of neurosurgery residents. The combination of a didactic and technical assessment appears to be synergistic in terms of educational development.

Recommended Citation

Ghobrial, MD, George M.; Anderson, Paul A; Chitale, MD, Rohan; Campbell, MD, Peter; Lobel, MD, Darlene A; and Harrop, MD, James, "Simulated spinal cerebrospinal fluid leak repair: an educational model with didactic and technical components." (2013). Department of Neurosurgery Faculty Papers. Paper 50.
https://jdc.jefferson.edu/neurosurgeryfp/50

PubMed ID

24051873