Development and Validation of a Low-Cost 3DPrinted Cervical Simulator for Fluoroscopy- Guided Nerve Block Training

Cervical nerve blocks require high precision due to the proximity of critical structures, such as the spinal cord and the vertebral and carotid arteries. Training opportunities are limited by the risks associated with fluoroscopy-guided procedures, ethical constraints of cadaveric models, and the high cost of commercial simulators. Three-dimensional (3D) printing offers an accessible and customizable alternative for procedural training. A cervical spine simulator was constructed from a multislice CT scan. The cervical spine (C1-C7) was segmented using 3D Slicer and processed in Meshmixer to generate an anatomical 3D model, which was printed in PLA. Soft tissues were reproduced using a ballistic gel formulation composed of glycerin, gelatin, and propylene glycol. Six physicians participated in a five-week training program performing facet, indirect, and direct cervical root blocks under fluoroscopy. Knowledge was assessed pre- and post-training, performance was assessed weekly using OSATS, and validity was evaluated through a Likert-scale survey. This 3D-printed cervical simulator proved to be a valid, low-cost, and reproducible tool for training fluoroscopy-guided cervical nerve blocks.