Combining Virtual Surgical Planning and Patient-Specific 3D-Printing As a Solution to Complex Spinal Revision Surgery

Overview

Journal J Pers Med

Date 2023 Jan 21

PMID 36675680

Authors

David A M Tredan

Ralph J Mobbs

Monish Maharaj

William C H Parr

Affiliations

Soon will be listed here.

Abstract

With the advent of three-dimensional printing, rapid growth in the field and application in spinal and orthopedic surgery has been seen. This technology is now being applied in creating patient-specific implants, as it offers benefits over the generic alternative, with growing literature supporting this. This report details a unique application of virtual surgical planning and manufacture of a personalized implant in a case of cervical disc replacement failure with severe osteolysis and resultant hypermobility. Where this degree of degenerative bone loss would often necessitate a vertebrectomy to be performed, this case highlights the considerable customizability of 3D-printed patient-specific implants to contour to the bony defects, allowing for a smaller and safer operation, with the achievement of stability as early as 3 months after the procedure, by the presence of osseointegration. With increasing developments in virtual planning technology and 3D printing ability, the future of complex spinal revision surgery may adopt these technologies as it affords the patient a faster, safer, and less invasive and destructive procedure.

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References

Lal H, Patralekh M . 3D printing and its applications in orthopaedic trauma: A technological marvel. J Clin Orthop Trauma. 2018; 9(3):260-268. PMC: 6128305. DOI: 10.1016/j.jcot.2018.07.022. View

Mishra A, Verma T, Vaish A, Vaish R, Vaishya R, Maini L . Virtual preoperative planning and 3D printing are valuable for the management of complex orthopaedic trauma. Chin J Traumatol. 2019; 22(6):350-355. PMC: 6921216. DOI: 10.1016/j.cjtee.2019.07.006. View

Pichelmann M, Lenke L, Bridwell K, Good C, OLeary P, Sides B . Revision rates following primary adult spinal deformity surgery: six hundred forty-three consecutive patients followed-up to twenty-two years postoperative. Spine (Phila Pa 1976). 2009; 35(2):219-26. DOI: 10.1097/BRS.0b013e3181c91180. View

Mobbs R, Choy W, Wilson P, McEvoy A, Phan K, Parr W . L5 En-Bloc Vertebrectomy with Customized Reconstructive Implant: Comparison of Patient-Specific Versus Off-the-Shelf Implant. World Neurosurg. 2018; 112:94-100. DOI: 10.1016/j.wneu.2018.01.078. View

Sing S, An J, Yeong W, Wiria F . Laser and electron-beam powder-bed additive manufacturing of metallic implants: A review on processes, materials and designs. J Orthop Res. 2015; 34(3):369-85. DOI: 10.1002/jor.23075. View

Mierzejewska Z, Hudak R, Sidun J . Mechanical Properties and Microstructure of DMLS Ti6Al4V Alloy Dedicated to Biomedical Applications. Materials (Basel). 2019; 12(1). PMC: 6337110. DOI: 10.3390/ma12010176. View

Trevisan F, Calignano F, Aversa A, Marchese G, Lombardi M, Biamino S . Additive manufacturing of titanium alloys in the biomedical field: processes, properties and applications. J Appl Biomater Funct Mater. 2017; 16(2):57-67. DOI: 10.5301/jabfm.5000371. View

Truumees E, Demetropoulos C, Yang K, Herkowitz H . Failure of human cervical endplates: a cadaveric experimental model. Spine (Phila Pa 1976). 2003; 28(19):2204-8. DOI: 10.1097/01.BRS.0000084881.11695.50. View

Suh P, Puttlitz C, Lewis C, Bal B, McGilvray K . The Effect of Cervical Interbody Cage Morphology, Material Composition, and Substrate Density on Cage Subsidence. J Am Acad Orthop Surg. 2016; 25(2):160-168. DOI: 10.5435/JAAOS-D-16-00390. View

10.

Sheha E, Gandhi S, Colman M . 3D printing in spine surgery. Ann Transl Med. 2019; 7(Suppl 5):S164. PMC: 6778284. DOI: 10.21037/atm.2019.08.88. View

11.

Vaishya R, Patralekh M, Vaish A, Agarwal A, Vijay V . Publication trends and knowledge mapping in 3D printing in orthopaedics. J Clin Orthop Trauma. 2018; 9(3):194-201. PMC: 6128796. DOI: 10.1016/j.jcot.2018.07.006. View

12.

Rajaee S, Kanim L, Bae H . National trends in revision spinal fusion in the USA: patient characteristics and complications. Bone Joint J. 2014; 96-B(6):807-16. DOI: 10.1302/0301-620X.96B6.31149. View

13.

Choi H, Purushothaman Y, Baisden J, Rajasekaran D, Jebaseelan D, Yoganandan N . Comparative Finite Element Modeling Study of Anterior Cervical Arthrodesis Versus Cervical Arthroplasty With Bryan Disc or Prodisc C. Mil Med. 2021; 186(Suppl 1):737-744. DOI: 10.1093/milmed/usaa378. View

14.

Joaquim A, Lee N, Riew K . Revision Surgeries at the Index Level After Cervical Disc Arthroplasty - A Systematic Review. Neurospine. 2021; 18(1):34-44. PMC: 8021828. DOI: 10.14245/ns.2040454.227. View

15.

Kalakoti P, Missios S, Maiti T, Konar S, Bir S, Bollam P . Inpatient Outcomes and Postoperative Complications After Primary Versus Revision Lumbar Spinal Fusion Surgeries for Degenerative Lumbar Disc Disease: A National (Nationwide) Inpatient Sample Analysis, 2002-2011. World Neurosurg. 2015; 85:114-24. DOI: 10.1016/j.wneu.2015.08.020. View

16.

Mok J, Cloyd J, Bradford D, Hu S, Deviren V, Smith J . Reoperation after primary fusion for adult spinal deformity: rate, reason, and timing. Spine (Phila Pa 1976). 2009; 34(8):832-9. DOI: 10.1097/BRS.0b013e31819f2080. View

17.

Ventola C . Medical Applications for 3D Printing: Current and Projected Uses. P T. 2014; 39(10):704-11. PMC: 4189697. View

18.

Mobbs R, Parr W, Huang C, Amin T . Rapid Personalised Virtual Planning and On-Demand Surgery for Acute Spinal Trauma Using 3D-Printing, Biomodelling and Patient-Specific Implant Manufacture. J Pers Med. 2022; 12(6). PMC: 9224763. DOI: 10.3390/jpm12060997. View

19.

Xu H, Wang X, Han Y, Jiang Y, Wang J, Zhang X . Biomechanical comparison of different prosthetic reconstructions in total en bloc spondylectomy: a finite element study. BMC Musculoskelet Disord. 2022; 23(1):955. PMC: 9635202. DOI: 10.1186/s12891-022-05919-0. View

20.

Wilcox B, Mobbs R, Wu A, Phan K . Systematic review of 3D printing in spinal surgery: the current state of play. J Spine Surg. 2017; 3(3):433-443. PMC: 5637198. DOI: 10.21037/jss.2017.09.01. View