The use of physical biomodelling in complex spinal surgery

Abstract

Prior studies have suggested that biomodels enhance patient education, preoperative planning and intra-operative stereotaxy; however, the usefulness of biomodels compared to regular imaging modalities such as X-ray, CT and MR has not been quantified. Our objective was to quantify the surgeon's perceptions on the usefulness of biomodels compared to standard visualisation modalities for preoperative planning and intra-operative anatomical reference. Physical biomodels were manufactured for a series of 26 consecutive patients with complex spinal pathologies using a stereolithographic technique based on CT data. The biomodels were used preoperatively for surgical planning and customising implants, and intraoperatively for anatomical reference. Following surgery, a detailed biomodel utility survey was completed by the surgeons, and informal telephone interviews were conducted with patients. Using biomodels, 21 deformity and 5 tumour cases were performed. Surgeons stated that the anatomical details were better visible on the biomodel than on other imaging modalities in 65% of cases, and exclusively visible on the biomodel in 11% of cases. Preoperative use of the biomodel led to a different decision regarding the choice of osteosynthetic materials used in 52% of cases, and the implantation site of osteosynthetic material in 74% of cases. Surgeons reported that the use of biomodels reduced operating time by a mean of 8% in tumour patients and 22% in deformity procedures. This study supports biomodelling as a useful, and sometimes essential tool in the armamentarium of imaging techniques used for complex spinal surgery.

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

“…A full-scale, stereoscopic understanding of the pathology allows for more detailed planning and simulation of the procedure (10)(11)(12)(13)(14)(15)(16)(17)(18)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(50)(51)(52). Assessing complex pathologies on a model overcomes many of the issues associated with traditional 3D imaging, such as the lack of realistic anatomical representation and the associated complexity of computer-related skills and techniques (10,12).…”

Utility of multimaterial 3D printers in creating models with pathological entities to enhance the training experience of neurosurgeons

“…With the advent of 3D printers, models have been created using actual patient data to aid in the planning of complex surgical procedures as well as to explain such procedures to patients and their relatives. [1][2][3]6,8,12 However, until now most of these models have been constructed from a single material, and therefore have lacked certain details and realism. On the other hand, models with varying tissue properties described previously are expensive and difficult to make.…”

A survey of the “surgical and research” articles in the European Spine Journal, 2007

“…One of the most exciting papers was that by Izatt et al [24] dealing with the use of a physical model of the deformed spine, created from three dimensional CT images, called stereolithographic biomodelling, and used to help the surgeon plan and execute surgery. Twenty-eight sequential complex deformity patients were modelled, 22 models in 21 patients with deformity, and 6 models in 5 patients with tumors.…”