Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques - a systematic review of the current literature

Morosanu, C. O. and Nicolae, L. and Moldovan, R. and Farcasanu, A. S. and Filip, G. A. and Florian, I. S.

Neurol Neurochir Pol (2019) 53: 8–17

DOI: 10.5603/PJNNS.a2019.0001

Abstract

INTRODUCTION: Due to its high complexity, neurosurgery consists of a demanding learning curve that requires intense training and a deep knowledge of neuroanatomy. Microsurgical skill development can be achieved through various models of simulation, but as human cadaveric models are not always accessible, cadaveric animal models can provide a reliable environment in which to enhance the acquisition of surgical dexterity. The aim of this review was to analyse the current role of animal brains in laboratory training and to assess their correspondence to the procedures performed in humans. MATERIAL AND METHODS: A Pubmed literature search was performed to identify all the articles concerning training cranial and spinal techniques on large animal heads. The search terms were ’training model’, and ’neurosurgery’ in association with ’animal’, ’sheep’, ’cow’, and ’swine’. The exclusion criteria were articles that were on human brains, experimental fundamental research, or on virtual simulators. RESULTS: The search retrieved 119 articles, of which 25 were relevant to the purpose of this review. Owing to their similar neuroanatomy, bovine, porcine and ovine models prove to be reliable structures in simulating neurosurgical procedures. On bovine skulls, an interhemispheric transcalosal and retrosigmoid approach along with different approaches to the Circle of Willis can be recreated. Ovine model procedures have varied from lumbar discectomies on sheep spines to craniosynostosis surgery, whereas in ex vivo swine models, cadaveric dissections of lateral sulcus, median and posterior fossa have been achieved. CONCLUSIONS: Laboratory training models enhance surgical advancements by familiarising trainee surgeons with certain neuroanatomical structures and promoting greater surgical dexterity. The accessibility of animal brains allows trainee surgeons to exercise techniques outside the operating theatre, thus optimising outcomes in human surgical procedures.

Citation

Morosanu, C. O., Nicolae, L., Moldovan, R., Farcasanu, A. S., Filip, G. A., & Florian, I. S. (2019). Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques - a systematic review of the current literature. Neurol Neurochir Pol, 53(1), 8–17. https://doi.org/10.5603/PJNNS.a2019.0001 Animals, Humans, training, *Neurosurgery, *Skull, Cadaver, cadaveric, large animals, neurosurgical model, Neurosurgical Procedures

Keywords

• Animals
• Humans
• training
• *Neurosurgery
• *Skull
• Cadaver
• cadaveric
• large animals
• neurosurgical model
• Neurosurgical Procedures