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The orthoSIM service is the generalization of a new concept developed within the DEVASPIM European Craft project between August 2002 and August 2004 and which successfully concluded with the setup of the lower-spine simulation portal called Mywebspine.com (http://www.mywebspine.com).
DEVASPIM was a research and development project funded under the Fifth European Framework Programme (IST Programme), in order to develop a virtual assistant to help orthopaedic surgeons and implant manufacturers to minimize failure cases due to inappropriate implants or implant configurations in the lumbar spine.
The application offered automated simulation services to surgeons and implant designers, based on a user-friendly interface that permits on-line data acquisition for customizing patient model, implant model as well as surgical technique, thus rendering to final users the simulation results in an easy and practical format.
The portal’s design put significant efforts in highlighting and facilitating the following topics:
- Its dual services, both for surgeons and for implant designers
- The convergence of commercial and scientific objectives.
- The usability of the portal’s perfomances.
- The possibility of customizing its major functionalities.

Surgical planning simulation
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The requirements for using the portal (client’s software and hardware configuration) were simple and universal, no proprietary software was required and only a browser was needed to operate the portal.
After DEVASPIM was finished, the same consortium decided to carry out further technical improvements to the platform, as well as conduct a market validation in several European countries. This was the seed of the orthoSIM European project under the eTEN Programme, which started in 2005 and lasted until 2007.
The main goal of this project was to validate the potential market at European scale for introducing a new service concept which we called ‘The European Simulation Service Provider for orthopaedic surgery’ (orthoSIM), aimed at both the health community and the implant industry.
orthoSIM would deliver added-value services around its main offer: virtual preoperative analyses of the behaviour of an orthopaedic implant after implantation in a customized implant-patient configuration.
The objectives of market validation were to identify the specific market stakeholders in each of the deployment countries; adapt the service interface to the local characteristics and test the user response for each of the service categories in form of “warm tests” for clinicians and implant designers.
Since users were not the direct purchasers of the system, “cold tests” were envisioned to check for the buy-channel specifities in each country.
Furthermore, since business development is fully based on the integration of new implants and new models into the system, additional “integration tests” were planned to test its problematic and develop standard integration protocols.
After analysis of the market tests, a business plan was developed as part of a overall plan for complete market deployment. In parallel, a far reaching dissemination plan was deployed, comprising not only scientific publications and technical communications, but also workshops where users of the system and related professional associations were invited to share their experiences in public.
Continuous scientific validation of each model together with adequate dissemination of these results to professional associations, private hospital consortia and public health authorities are key success factors of the project.
To convince clinical users of the benefits of using the system is our present goal. New academic initiatives are under way to provide training and help to potential users of this service (see orthoTRAINING).
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