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A Low-Cost, Durable, Combined Ultrasound and Fluoroscopic Phantom for Cervical Transforaminal Injections
  1. Imanuel R. Lerman, MD, MS*,
  2. Dmitri Souzdalnitski, MD, PhD and
  3. Samer Narouze, MD, MS
  1. From the *Massachusetts General Hospital, Boston, MA;
  2. AnesthesiologyInstitute, Department of Pain Medicine, Cleveland Clinic Foundation, Cleveland,OH; and
  3. Center for Pain Medicine, Summa Western Reserve Hospital, Cuyahoga Falls, OH.
  1. Address correspondence to: Imanuel R. Lerman, MD, MS, Massachusetts General Hospital, Department of Anesthesiology Critical Care and Pain Medicine, 55 Fruit St. Boston MA (e-mail: irlerman{at}


Background This technical report describes a durable, low-cost, anatomically accurate, and easy-to-prepare combined ultrasound (US) and fluoroscopic phantom of the cervical spine. This phantom is meant to augment training in US- and fluoroscopic-guided pain medicine procedures.

Methods The combined US and fluoroscopic phantom (CUF-P) is prepared from commercially available liquid plastic that is ordinarily used to prepare synthetic fishing lures. The liquid plastic is heated and then poured into a metal canister that houses an anatomical cervical spine model. Drops of dark purple dye are added to make the phantom opaque. After cooling, tubing is attached to the CUF-P to simulate blood vessels.

Results The CUF-P accurately simulates human tissue by imitating both the tactile texture of skin and the haptic resistance of human tissue as the needle is advanced. This phantom contains simulated fluid-filled vertebral arteries that exhibit pulsed flow under color Doppler US. Under fluoroscopic examination, the CUF-P–simulated vertebral arteries also exhibit uptake of contrast dye if mistakenly injected.

Conclusions The creation of a training phantom allows the pain physician to practice needle positioning technique while simultaneously visualizing both targeted and avoidable vascular structures under US and fluoroscopic guidance. This low-cost CUF-P is easy to prepare and is reusable, making it an attractive alternative to current homemade and commercially available phantom simulators.

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  • This study was supported by the Yale New Haven Hospital Resident Education Fund.

  • This information was presented as an abstract at the spring 2010 Annual ASRA Regional Anesthesia Pain Meeting, Toronto, Canada.