Disclosures: Evan M. Berlin, MD: No financial relationships or conflicts of interest

Objective: There are a growing number of graduating PM&R residents who plan to perform interventional spine procedures using fluoroscopic guidance. Currently, ACGME guidelines require residents to observe or perform at least 5 interventional spine procedures. There is no standardized curriculum for teaching these procedures during residency. This study’s objective was to assess the feasibility and effectiveness of a spine curriculum utilizing a cadaver lab.

Design: With an instructor’s guidance, PM&R residents were accompanied to a cadaver lab. A fresh frozen cadaver, mobile C-arm fluoroscope, spinal needles, and protective lead were utilized. Residents were introduced to C-arm movements and directional commentary. They were then exposed to spine anatomy in standard procedural views. Once comfortable with imaging, residents demonstrated various procedural skills, including creating superficial skin wheels, needle driving techniques, and procedural approaches (transforaminal and interlaminar epidural injections, medial branch blocks, and sacroiliac joint injections). After one session, residents were given surveys to rate their confidence on a 0-10 scale regarding these procedures.Setting : Cadaver labParticipants : PM&R residents

Interventions: Cadaver-based spine procedure curriculum

Main Outcome Measures: Resident confidence with spine procedures

Results: A total of 8 residents participated in this protocol. Confidence in maneuvering the C-arm increased an average of 5.3 points. Confidence in ability to identify spine anatomy under fluoroscopy increased an average of 3.3 points. Confidence in ability to drive the needle increased an average of 4.0 points. Lastly, when asked how beneficial the cadaver lab was for education and training, residents rated the experience, on average (SD), at 8.8 (2.3).Conclusions: To our knowledge, this is the first cadaver lab protocol focused on developing interventional spine procedural basics for PM&R residents. The cadaver lab is likely an underutilized setting for developing procedural skills. While this is not a replacement for ACGME recorded clinical interactions, it may serve as a tool to improve resident preparedness for spine procedures.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/development-and-assessment-of-a-cadaver-lab-curriculum-for-spine-procedure-training-during-residency/