Visualization of the history of cervical spine surgical techniques
Featured in the Journal of Spine Surgery
The visual challenge: How to create accurate representations of spinal surgery with limited historical references
Cervical spine surgical techniques to correct bone diseases and disorders in the neck have evolved dramatically over the last 100 years. These types of surgeries are complicated due to the elaborate bone and vascular anatomy of the neck. It is critical for surgeons to understand how and why surgical techniques have changed and how advances relate to the complex anatomy of this region.
For the article Posterior atlantoaxial fusion: a comprehensive review of surgical techniques and relevant vascular anomalies, Drs. Brian T. David and Richard Fessler from Rush University Department of Neurosurgery, and colleagues, carefully reviewed techniques developed throughout the previous century to treat cervical spine pathologies. Most of these techniques involve fusing the first two vertebrae of the spine together to stabilize the neck and reduce symptoms, such as numbness and pain.
The surgeons needed visual representations of the various surgeries, but many of these historical techniques have limited references. Isabel Romero Calvo, MS, PhD, Creative Director of Morphology, was excited about this challenge of creating accurate and beautiful illustrations of ten historical surgical techniques for this comprehensive review.
The solution: Combine traditional and digital art with a strong knowledge of anatomy
Isabel initiates her process of creation by researching and studying the topic. In this case, she utilized numerous academic resources, including real human vertebrae as models for the structures.
“I have learned over time that the research step is the most important part of a project. It is a fundamental process for laying a strong scientific foundation before moving into composition, color, and rendering approaches,” Isabel commented.
Black and white anatomical study of the Axis (C2 vertebra)
Aureolin yellow, rose madder, and cobalt blue: three pure transparent pigments utilized for final render
The process for rendering the vertebrae was to use traditional watercolor for a natural and organic look and feel. The color palette selection was based on pure transparent pigments, aureolin yellow, rose madder, and cobalt blue, to allow for layering of paint to create a subtle effect of light and shadow, and a sense of texture of the bone surface.
Final illustrations combine traditional watercolor with vector graphics
After creating the final watercolor composition, Isabel utilized digital vector graphics techniques to create the surgical instruments. When available, she used the surgical hardware as a reference, but for some techniques, it was necessary to extrapolate the forms from x-rays and other types of medical imaging.
The final illustrations are a collection of ten artistic and accurate visualizations of the surgical procedures that give an historical overview to vertebrae fusion surgeries of the neck. See the complete review article with illustrations here: http://jss.amegroups.com/article/view/4935.