Research Day

A SACROILIAC JOINT SIMULATOR FOR ULTRASOUND GUIDED SI JOINT INJECTIONS TRAINING

Document Type

Abstract

Date

2021

Abstract

Introduction: Injection of the sacroiliac (SI) joint is an important treatment modality for patients with low back pain with and without spondyloarthropathies of SI joint. Performing the procedure using landmarks fails to reach the sacroiliac joint space in most cases. Ultrasound guidance can improve the success rate. No ultrasound capable SI joint injection simulator is commercially available to train physicians. Similar simulators for other joints cost $1,500-$7,000. We set out to create a low-cost high-fidelity SI joint injection simulator.

Methods: A plaster cast was taken of the lumbosacral region of a volunteer and rendered waterproof using a latex sealant. Artificial foam bones of the sacrum and pelvis ($78) was obtained from Sawbones™ straight pins supported the bones in the cast. Six liters of ballistic gel was made using high concentrations of Knox® gelatin ($15). Gelatin was poured into the mold and refrigerated one liter at a time to avoid floating of the foam bones from the desired location.

Results: Three ultrasound capable SI joint simulator were created from the same mold and used to train an average of 45 internal medicine, med-peds and family medicine residents and third and fourth year medical students. Learners had the opportunity to visualize the needle insertion into the sacroiliac joint using dynamic ultrasound. Since the gel is transparent the learner can correlate the image on the ultrasound machine with direct visual inspection of the needle and pelvic anatomy.

Discussion: A low-cost, high-fidelity simulator can be created to train learners on SI joint injections.

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