TissueDB/Simulators/Lumbar Laminectomy and Dural Closure Simulator (Bakhshi)
The Lumbar Laminectomy and Dural Closure Simulator (Bakhshi) is a low-cost spine model, built in-house from a saw-bone spine, foam and a latex glove, for practising a lumbar laminectomy and closing the dura. A saw-bone lumbar spine (L1 to S1) sits inside a foam-and-rexine block that opens like a book, with a latex-glove dura beneath. Trainees remove the lamina with a bone nibbler and Kerrison rongeur under a microscope, then suture the dura closed. It was built in-house for the first low-cost, multi-centre national neurosurgery bootcamp for postgraduate year-1 residents in Karachi, Pakistan.[1]
| Field | Details |
|---|---|
| Features and Basic Operation | The book-fold block opens to present the spine: the lower half houses the saw-bone spine model and the upper half carries a slit representing the incision. Lumbar spine retractors widen the opening for exposure. Trainees remove the lamina and then suture the latex-glove dura closed under the microscope. The source notes the difficulty can be increased by building in more depth.[1] |
| Current Development Status | Built in-house and used in a national neurosurgery bootcamp (22 PGY-1 residents); not yet systematically validated for training (the dural-closure step was not evaluated in the bootcamp).[1] |
| Estimated Build Time and Cost | US$60 |
| Specialized Tools and Equipment | A bone nibbler and Kerrison rongeur for the laminectomy, lumbar spine retractors to widen the exposure, and an operating microscope for the laminectomy and dural suturing. The dural closure uses a 6-0 Prolene suture — a use-time consumable, provided free of charge by the vendors in the source bootcamp, not a build material.[1] |
| Version | Version 1 |
| Development Team Contact Information | Saqib Kamran Bakhshi, Medical College, Aga Khan University, Karachi, Pakistan; saqib.bakhshi@aku.edu. Part of the national neurosurgery bootcamp at Aga Khan University Hospital. |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Bone | 1 (L1–S1) | Saw-bone spine model | — | A synthetic saw-bone lumbar spine (L1 to S1); its lamina is the target of the laminectomy. ⚑ Open for review: "saw-bone" is a brand-generic term for synthetic surgical bone — the dedicated material class (e.g. Synthetic Bone) is a naming decision for Felipe.[1] |
| Skin | 1 | Foam covered with rexine | — | A book-fold block of foam covered with rexine (a coated fabric): the upper half carries a slit representing the incision and the lower half houses the spine model. ⚑ Open for review: class anchored to Skin (the incised soft-tissue surface) as the closest fit; the block also serves as the spine housing, but it is classed as a tissue because its main job is to stand in for the soft tissue the surgeon incises. "Rexine" is a brand-generic coated fabric — the dedicated material class (e.g. Coated Fabric) is a naming decision for Felipe.[1] |
| Dura Mater | 1 | Latex glove | — | A latex glove mounted on a 5 cc syringe window, simulating the dura that trainees suture closed during dural closure. ⚑ Open for review: linked to the Latex Sheet material class (the canonical latex material); a dedicated latex-glove working-form class is a naming decision for Felipe.[1] |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Dura backing | 1 | 5 cc plastic syringe | — | A 5 cc plastic syringe with a window cut in the middle; the latex-glove dura is pasted over it to present the dura at the laminectomy site.[1] |
Build Instructions
Phase 1: Build the spine simulator
Step 1: Make the book-fold soft-tissue block. Cut two foam components and cover them with rexine, hinged so the block opens like a book. Leave a space in the middle of the lower half for the spine model, and cut a slit in the upper half to represent the incision, because the trainee enters through this slit to reach the spine.[1]
Step 2: Seat the spine model. Fit the saw-bone lumbar spine model (L1 to S1) into the space in the lower half of the block.[1]
Step 3: Make and place the dura. Cut a window in the middle of a 5 cc plastic syringe and paste a latex glove over it to simulate the dura; place it beneath the laminectomy site so it can be reached once the lamina is removed.[1]
Checkpoint: Confirm the block opens like a book, the spine model is seated in the lower half, the incision slit is in the upper half, and the latex-glove dura sits beneath the laminectomy site.
Phase 2: Set up and operate
Step 1: Expose the spine. Open the block and apply lumbar spine retractors to widen the incision slit for better exposure of the spine model.[1]
Step 2: Perform the laminectomy. Remove the lamina from the saw-bone spine with a bone nibbler and Kerrison rongeur under the operating microscope, exposing the dura beneath.[1]
Step 3: Close the dura. Suture the latex-glove dura closed with 6-0 Prolene under the microscope, practising the fine dural-closure technique.[1]
Checkpoint: Verify the lamina is removed, the dura is exposed, and the dural suture line is complete and watertight in appearance.
Not suitable for / known limitations
The source did not evaluate the simulated dural-closure step during the bootcamp — it required more than three attempts to become proficient — but notes the model can be used for lab practice. The simulator has not yet been systematically validated for formal training. The source states the difficulty can be increased by building in more depth.[1]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 Bakhshi SK, Ahmad R, Merchant AAH, Noorali AA, Abdul Rahim K, Shaikh NQ, Afzal N, Lakhdir MPA, Shamim MS, Haider AH. "Development, outcome and costs of a simulation-based neurosurgery bootcamp at the national level." BMC Medical Education 2022;22:896. DOI: 10.1186/s12909-022-03965-9. PMID: 36578075. PMC9795592. Licensed CC BY 4.0.
See also
[edit | edit source]- Cranial Burr Hole and Craniotomy Simulator (Bakhshi) — the cranial-access station of the same Bakhshi neurosurgery bootcamp family.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Lumbar Laminectomy and Dural Closure Simulator (Bakhshi)". Appropedia. Retrieved July 7, 2026. |