Individualized 3D printing-assisted repair and reconstruction of neoplastic bone defects at irregular bone sites: exploration and practice in the treatment of scapular aneurysmal bone cysts

Abstract

Background The irregular anatomical shape and complex structures of irregular bones make it more difficult to repair and reconstruct bone defects in irregular bones than in the long bones of the extremities. Three-dimensional (3D) printing technology can help to overcome the technical limitations of irregular bone repair by generating simulations that enable structural integration of the lesion area and bone structure of the donor site in all directions and at multiple angles. Thus, personalized and accurate treatment plans for restoring anatomical structure, muscle attachment points, and maximal function can be made. The present study aimed to investigate the ability of 3D printing technology to assist in the repair and reconstruction of scapular aneurysmal ABC defects. Methods The study included seven patients with ABCs of the scapula. Based on computed tomography (CT) data for the patient, the scapula (including the defect) and pelvis were reconstructed using Mimics Medical software. The reconstructed scapula model was printed using a 3D printer. Before the operation, the model was used to design the surgical approach and simulate the operation process, to determine the length and radius of the plate and the number and direction of screws, and to determine the bone mass of the ilium and develop reasonable strategies for segmentation and distribution. The operation time, amount of bleeding, length and radius of the plate, and direction and number of screws were recorded. Results The average duration of follow-up was 25.6 months, and none of the seven patients experienced recurrence during the follow-up period. The surgical approach, the length and radius of internal fixation, and the number and direction of screws were consistent with the designed operation plan. Patients gradually recovered the anatomical structure of the scapula and function of the shoulder joint. Conclusions In the treatment of bone defects caused by irregular bone tumors, 3D printing technology combined with surgery has the advantages of less trauma, short operation time, less bleeding and reducing the difficulty of operation, which can reduce the waste of bone graft, and more complete reconstruction of the anatomical structure of the defective bone.

Application of artificial intelligence in 3D printing physical organ models

“…After acquiring CT images, the images need to be processed. Mimics is a professional 3D medical image processing software mainly used for model reconstruction, segmentation, restoration, and smoothing operations while supporting many different image formats and multiple export formats [ [41] , [42] , [43] ]. With its user-friendly interface and easy operation, Mimics is suitable for beginners or non-professionals in medical image processing.…”

The treatment of aneurysmal bone cysts

“…A large amount of case series into rare locations of ABCs have been published recently [ 47 , 48 ▪ ]. Localization of ABC in the hands and feet had significantly less recurrences compared with other locations in Döring et al [ 42 ].…”

“…In pelvic and sacral ABCs, because of fragility of surrounding soft tissue structures, a growing interest for percutaneous procedures has been justified by reports of successful treatment with polidocanol, SAE or combination of the two [ 40 , 48 ▪ ]. However, for some larger lesions, surgical curettage remains the preferred option.…”