{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:46:34Z","timestamp":1791740794142,"version":"4.3.4"},"reference-count":11,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Proc Inst Mech Eng H"],"abstract":"<jats:p>Fluoroscopy-guided spinal interventions require anatomically representative and radiographically compatible physical models for procedural simulation. Cadaveric specimens and animal models, while valuable, are limited by cost, availability, ethical considerations, and restricted repeatability. These limitations motivate the development of cost-efficient lumbar spine simulators compatible with C-arm fluoroscopic imaging. Vertebrae and pelvic structures were generated from open-source STL files and fabricated using fused deposition modeling. Post-processing included surface polishing and fabrication of silicone molds to reproduce vertebral geometry. Combinations of two-component polyurethane casting resin, calcium sulfate, barium sulfate, and iohexol were tested to evaluate radiographic visibility and identify a suitable radiopaque formulation. Vertebral elements were assembled using silicone interfaces to form puncturable intervertebral spaces. Soft tissues and skin were imitated using gelatin-glycerin foam and pigmented silicone. Radiographic appearance was assessed under C-arm fluoroscopy. Among the tested formulations, polyurethane composite containing 5\u2009wt% calcium sulfate provided sufficient radiographic visibility while avoiding excessive radiopacity and was selected for the final simulator. The simulator reproduced key lumbar anatomical features and enabled clear visualization of the needle trajectory under fluoroscopy. Design optimization produced a lighter and more compact configuration than the initial prototype. This study presents a reproducible 3D-printed lumbar spine simulator with tunable radiographic properties compatible with fluoroscopic imaging. The proposed design provides a cost-efficient physical model for image-guided procedural simulation and technical development, intended for non-commercial academic and educational use.<\/jats:p>","DOI":"10.1177\/09544119261494035","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:36:40Z","timestamp":1791448600000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Design and fabrication of a lumbar spine simulator for fluoroscopy-guided intervertebral disk puncture"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0750-3017","authenticated-orcid":false,"given":"Aleksandr","family":"Ozherelev","sequence":"first","affiliation":[{"name":"School of Biomedicine, Far Eastern Federal University, Vladivostok, Primorsky Krai, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Bandur","sequence":"additional","affiliation":[{"name":"School of Biomedicine, Far Eastern Federal University, Vladivostok, Primorsky Krai, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Polkin","sequence":"additional","affiliation":[{"name":"School of Biomedicine, Far Eastern Federal University, Vladivostok, Primorsky Krai, Russia"},{"name":"Department of Neurosurgery, 1477th Naval Clinical Hospital, Vladivostok, Primorsky Krai, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Goncharuk","sequence":"additional","affiliation":[{"name":"School of Biomedicine, Far Eastern Federal University, Vladivostok, Primorsky Krai, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","unstructured":"Kirnaz S Capadona C Wong T et al. Fundamentals of intervertebral disc degeneration. World Neurosurg 2022; 157: 264\u2013273. https:\/\/doi.org\/10.1016\/j.wneu.2021.09.066","DOI":"10.1016\/j.wneu.2021.09.066"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-020-06536-y"},{"key":"e_1_3_3_4_2","doi-asserted-by":"crossref","unstructured":"Byvaltsev V Polkin R Bereznyak D et al. 3D-printed cranial models simulating operative field depth for microvascular training in neurosurgery. Surg Neurol Int 2021; 12: 213. https:\/\/doi.org\/10.25259\/SNI_849_2020","DOI":"10.25259\/SNI_849_2020"},{"key":"e_1_3_3_5_2","doi-asserted-by":"crossref","unstructured":"Reznick RK MacRae H. Teaching surgical skills \u2014 changes in the wind. N Engl J Med 2006; 355: 2664\u20132669. https:\/\/doi.org\/10.1056\/nejmra054785","DOI":"10.1056\/NEJMra054785"},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","unstructured":"Oblich MC Lyman JG Jain R et al. Resident training in minimally invasive spine surgery: a scoping review. Brain Sci 2025; 15: 936. https:\/\/doi.org\/10.3390\/brainsci15090936","DOI":"10.3390\/brainsci15090936"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0000000000000349"},{"key":"e_1_3_3_8_2","doi-asserted-by":"crossref","unstructured":"Romaniyanto F Mahyudin F Utomo DN et al. Effectivity of puncture method for intervertebral disc degeneration animal models: review article. Ann Med Surg 2023; 85: 3501\u20133505. https:\/\/doi.org\/10.1097\/MS9.0000000000000829","DOI":"10.1097\/MS9.0000000000000829"},{"key":"e_1_3_3_9_2","doi-asserted-by":"crossref","unstructured":"Faulkner AR Bourgeois AC Bradley YC et al. Simulation-based educational curriculum for fluoroscopically guided lumbar puncture improves operator confidence and reduces patient dose. Acad Radiol 2015; 22: 668\u2013673. https:\/\/doi.org\/10.1016\/j.acra.2014.12.024","DOI":"10.1016\/j.acra.2014.12.024"},{"key":"e_1_3_3_10_2","doi-asserted-by":"crossref","unstructured":"Koh JC Jang YK Seong H et al. Creation of a three-dimensional printed spine model for training in pain procedures. J Int Med Res 2021; 49: 03000605211053281. https:\/\/doi.org\/10.1177\/03000605211053281","DOI":"10.1177\/03000605211053281"},{"key":"e_1_3_3_11_2","doi-asserted-by":"crossref","unstructured":"Li Y Li Z Ammanuel S et al. Efficacy of using a 3D printed lumbosacral spine phantom in improving trainee proficiency and confidence in CT-guided spine procedures. 3D Print Med 2018; 4: 7. https:\/\/doi.org\/10.1186\/s41205-018-0031-x","DOI":"10.1186\/s41205-018-0031-x"},{"key":"e_1_3_3_12_2","doi-asserted-by":"crossref","unstructured":"Lerner DJ Gifford SE Olafsen N et al. Lumbar puncture: creation and resident acceptance of a low-cost durable reusable fluoroscopic phantom with a fluid-filled spinal canal for training at an academic program. 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