Applications of 3D printing in the management of severe spinal conditions

Provaggi, Elena; Leong, Julian; Kalaskar, Deepak M.

doi:10.1177/0954411916667761

Cited by 65 publications

(61 citation statements)

References 95 publications

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“…The introduction in orthopaedics, and more specifically in spinal surgery, is only recent and hence there is a lack of long-term follow-up in comparison to traditional techniques. As recently noted by Provaggi et al [2016], the pool of data specific to the spine continues to rapidly increase, though the quality of data is limited to case reports or cadaveric study (19). Additionally, there is no regulatory framework established that guides surgeons or companies as to how best have these implants registered or approved for production and implantation.…”

Section: Discussionmentioning

confidence: 99%

“…Across clinical studies by Chen et al [2015], the implementation of 3DP guide plate for lumbar fusion (n=43) demonstrated a marginal improvement in peri-operative outcomes and overall screw placement in comparison to those not using the guides (18). Including surgical guides, current applications of 3DP in spine care comprises mainly four areas of interest: surgical preplanning and training (models of the vertebral segments), surgical instrumentation (screw guide templates), implantable devices (interbody fusion cages, vertebral body replacement cages, disc implants for total disc replacement) and tissue engineering (scaffolds for cartilage regeneration) (19). These latter domains remain an area of interest with numerous studies into different synthesis techniques for implants, and differences in both 3DP material composition and architectural characteristics ongoing.…”

Section: Discussionmentioning

confidence: 99%

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Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis

Phan

Sgrò²,

Maharaj

et al. 2016

J. Spine Surg.

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The study aims to describe a three-dimensional printed (3DP) posterior fixation implant used for C1/ C2 fusion in a 65-year-old female. Spinal fusion remains a common intervention for a range of spinal pathologies including degenerative disc and facet disease when conservative methods are unsuccessful.However, fusion devices are not always entirely efficacious in providing the desired fixation, and surgeons rely on 'off the shelf' implants which may not provide an anatomical fit to address the particular pathology.3DP refers to a process where three-dimensional objects are created through successive layering of material, so called 'additive manufacturing'. Although this technology enables accurate fabrication of patient-specific orthopaedic and spinal implants, literature on its utilization in this regard is rare. A 65-year-old female, with severe facet arthropathy at the C1/C2 level, osteophyte formation and impingement of the exiting C2 nerve root underwent a C1/C2 posterior fusion and rhizolysis of the C2 nerve roots. A custom posterior fixation implant was designed and on-laid over the C2 spinous process and lamina, with screw holes made to a depth and angulation that was pre-calculated based on the preoperative CT based 3D modelling. The patient had an uneventful recovery and reported a significant reduction in occipital neuralgia and sub-occipital pain and 2-month follow-up. We report the first case of a customized 3DP spinal prosthesis for posterior C1/ C2 fusion. The implant added significant value reducing the overall time of the procedure, and safety with a reduced risk of neurovascular compromise.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis

Phan

Sgrò²,

Maharaj

et al. 2016

J. Spine Surg.

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“…As 3DP technology continues to become cheaper, faster and more accurate, its use in the setting of spinal surgery is likely to become routine, and in a greater number of procedures (1)(2)(3)(4)6,42,44,65). Lower cost desktop 3D printers for everyday use could soon be a reality, aiding real-time model and implant creation for more personalised surgical care (46,48).…”

Section: Future Directionsmentioning

confidence: 99%

“…Intra-operative guides, created with patient-specific data, may have the ability to jss.amegroups.com mitigate the risks associated with these procedures (4,54). Pedicle screws are a fixation technique routinely used in spinal surgery, as they are the most effective way to stabilize vertebrae (4,37,43) and lower the risk of complications if inserted accurately (31).…”

Section: Surgical Guidesmentioning

confidence: 99%

“…A variety of techniques can be used to print physical models from three-dimensional renderings based on CAD software, and STL design files. Whilst the use of this technology in medicine is still in its infancy, 3DP offers the possibility of revolutionising healthcare with its ability to rapidly create customized shapes from a wide range of materials (1)(2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

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Systematic review of 3D printing in spinal surgery: the current state of play

et al. 2017

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Three-dimensional printing (3DP), also known as "Additive Manufacturing", is a rapidly growing industry, particularly in the area of spinal surgery. Given the complex anatomy of the spine and delicate nature of surrounding structures, 3DP has the potential to aid surgical planning and procedural accuracy. We perform a systematic review of current literature on the applications of 3DP in spinal surgery. Six electronic databases were searched for original published studies reporting cases or outcomes for 3DP surgical models, guides or implants for spinal surgery. The findings of these studies were synthesized and summarized. These searches returned a combined 2,411 articles. Of these, 54 were included in this review. 3DP is currently used for surgical planning, intra-operative surgical guides, customised prostheses as well as "Off-the-Shelf" implants. The technology has the potential for enhanced implant properties, as well as decreased surgical time and better patient outcomes. The majority of the data thus far is from low-quality studies with inherent biases linked with the excitement of a new field. As the body of literature continues to expand, larger scale studies to evaluate advantages and disadvantages, and longer-term follow up will enhance our knowledge of the effect 3DP has in spinal surgery. In addition, issues such as financial impact, time to design and print, materials selection and bio-printing will evolve as this rapidly expanding field matures.

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Tensile Response Characterization and Constitutive Modeling of LPBF Ti6Al4V Thin Struts

et al. 2022

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Applications of 3D printing in the management of severe spinal conditions

Abstract: 12The latest and fastest-growing innovation in the medical field has been the advent of three-

Cited by 65 publications

References 95 publications

Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis

Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis

Systematic review of 3D printing in spinal surgery: the current state of play

Tensile Response Characterization and Constitutive Modeling of LPBF Ti6Al4V Thin Struts

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