Vital Role of In-House 3D Lab to Create Unprecedented Solutions for Challenges in Spinal Surgery, Practical Guidelines and Clinical Case Series

Abstract

For decades, the advantages of rapid prototyping for clinical use have been recognized. However, demonstrations of potential solutions to treat spinal problems that cannot be solved otherwise are scarce. In this paper, we describe the development, regulatory process, and clinical application of two types of patient specific 3D-printed devices that were developed at an in-house 3D point-of-care facility. This 3D lab made it possible to elegantly treat patients with spinal problems that could not have been treated in a conventional manner. The first device, applied in three patients, is a printed nylon drill guide, with such accuracy that it can be used for insertion of cervical pedicle screws in very young children, which has been applied even in semi-acute settings. The other is a 3D-printed titanium spinal column prosthesis that was used to treat progressive and severe deformities due to lysis of the anterior column in three patients. The unique opportunity to control size, shape, and material characteristics allowed a relatively easy solution for these patients, who were developing paraplegia. In this paper, we discuss the pathway toward the design and final application, including technical file creation for dossier building and challenges within a point-of-care lab.

Investigations on Factors Affecting 3D-Printed Holes Dimensional Accuracy and Repeatability

“…In this sense, additive manufacturing (AM) is not an exception considering the current trend towards using AM as a cost-effective, complementary solution to the traditional manufacturing technologies when it comes to mass customization production [1,2]. A shorter and less complex supply chain is another advantage of the AM technology [3], the implementation of the on-demand and delocalized production strategies by means of material extrusion-based AM process (MEX) recently proving its benefits [4,5]. However, there remain aspects related to the use of MEX for functional applications that require more investigation as the 3D prints mechanical properties, surfaces quality and accuracy strongly depend on parts design and process parameters settings [6].…”

“…Another objective of the research was to understand if the medical decontamination process had influenced the accuracy on the directly 3D-printed holes. Thus, 3D printing points-of-care (3DP-POCs), space, or other remote zones can be some of the beneficiaries of the results of this research, as locations in which the production of customized parts, spare parts, or low-volume parts takes place [5,23], with the manufacturing accuracy-related knowledge being relevant for obtaining reliable products.…”