scholarly journals 3D printed composite model of pelvic osteochondroma and nerve roots

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Olivia Fox ◽  
Andrew Kanawati

Abstract Background 3D-printing has become increasingly utilized in the preoperative planning of clinical orthopaedics. Surgical treatment of bone tumours within the pelvis is challenging due to the complex 3D bone structure geometry, as well as the proximity of vital structures. We present a unique case where a composite bone and nerve model of the lower lumbar spine, pelvis and accompanying nerve roots was created using 3D-printing. The 3D-printed model created an accurate reconstruction of the pelvic tumour and traversing nerves for preoperative planning and allowed for efficient and safe surgery. Case presentation We present a unique case where a composite bone and nerve model of the lower lumbar spine, pelvis and accompanying nerve roots was created using 3D-printing. The bony pelvis and spine model was created using the CT, whereas the nerve roots were derived from the MRI and printed in an elastic material. 3D-printed model created an accurate reconstruction of the pelvic tumour and traversing nerves for preoperative planning and allowed for efficient and safe surgery. Pelvic tumour surgery is inherently dangerous due to the delicate nature of the surrounding anatomy. The composite model enabled the surgeon to very carefully navigate the anatomy with a focused resection and extreme care knowing the exact proximity of the L3 and L4 nerve roots. Conclusion The patient had complete resection of this tumour, no neurological complication and full resolution of his symptoms due to careful, preoperative planning with the use of the composite 3D model.

2021 ◽  
Author(s):  
Olivia Fox ◽  
Andrew Kanawati

Abstract Purpose: 3D-printing has become increasingly utilized in the preoperative planning of clinical orthopaedics, orthopaedic trauma and other disciplines over the past decade. Surgical treatment of bone tumours within the pelvis is challenging due to the complex 3D bone structure geometry, as well as the proximity of vital structures such as blood vessels, nerve roots, sciatic and femoral nerves and the bladder and/or rectum. Methods: We present the first case where a composite bone and nerve model of the lower lumbar spine, pelvis and accompanying nerve roots was created using 3D-printing. The bony pelvis and spine was created using CT, whereas the nerve roots were printed in an elastic material with the aid of MRI. 3D-printed model created an accurate reconstruction of the pelvic tumour and traversing nerves for preoperative planning and allowed for efficient and safe surgery. Pelvic tumour surgery is inherently dangerous due to the delicate nature of the surrounding anatomy. Results: The composite model enabled the surgeon to very carefully navigate the anatomy with a focused resection and extreme care knowing the exact proximity of the L3 and L4 nerve roots. Conclusion: The patient had complete resection of this tumour, no neurological complication and full resolution of his symptoms due to careful, preoperative planning with the use of the composite 3D model.


2020 ◽  
Author(s):  
Fuyang Chen ◽  
Chenyu Huang ◽  
Chen Ling ◽  
Jinming Zhou ◽  
Yufeng Wang ◽  
...  

Abstract Background: Tibial plateau fracture is one of the common intra-articular fractures in clinic. And its accurate classification and treatment is a difficult problem for orthopedic surgeons. Our research aims to investigate the application value of 3D printing in the classification and preoperative planning of complex tibial plateau fractures.Methods: 28 cases of complex tibial plateau fractures diagnosed and treated in our hospital from January, 2017 to January, 2019.01 were analyzed. Preoperative spiral CT scan was performed and then DICOM data were input into the computer. We use Mimics to process data. And 3D printing technology was applied to print the 3D model of fracture (1:1). Combined with the 3D printed model, the tibial plateau fractures were subdivided into seven types according to the geometric plane of the tibial plateau. The surgical approach was determined on the 3D printed model. And then simulated operations such as accurate reduction of fracture and selection of plate placement were performed.Results: The reconstructed 3D model of tibial plateau fracture can accurately reflect the direction of fracture displacement and the degree of plateau collapse. Also, it and can help with the preoperative surgical design of tibial plateau fracture. The intraoperative fracture details were basically the same as the 3D printed model. And the fracture surface of the tibial plateau was well improved in all 28 cases.Conclusion: 3D printing technology can be used to guide the classification and preoperative planning of complex tibial plateau fractures.


BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e016891 ◽  
Author(s):  
Laura E Diment ◽  
Mark S Thompson ◽  
Jeroen H M Bergmann

ObjectiveTo evaluate the clinical efficacy and effectiveness of using 3D printing to develop medical devices across all medical fields.DesignSystematic review compliant with Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Data sourcesPubMed, Web of Science, OVID, IEEE Xplore and Google Scholar.MethodsA double-blinded review method was used to select all abstracts up to January 2017 that reported on clinical trials of a three-dimensional (3D)-printed medical device. The studies were ranked according to their level of evidence, divided into medical fields based on the International Classification of Diseases chapter divisions and categorised into whether they were used for preoperative planning, aiding surgery or therapy. The Downs and Black Quality Index critical appraisal tool was used to assess the quality of reporting, external validity, risk of bias, risk of confounding and power of each study.ResultsOf the 3084 abstracts screened, 350 studies met the inclusion criteria. Oral and maxillofacial surgery contained 58.3% of studies, and 23.7% covered the musculoskeletal system. Only 21 studies were randomised controlled trials (RCTs), and all fitted within these two fields. The majority of RCTs were 3D-printed anatomical models for preoperative planning and guides for aiding surgery. The main benefits of these devices were decreased surgical operation times and increased surgical accuracy.ConclusionsAll medical fields that assessed 3D-printed devices concluded that they were clinically effective. The fields that most rigorously assessed 3D-printed devices were oral and maxillofacial surgery and the musculoskeletal system, both of which concluded that the 3D-printed devices outperformed their conventional comparators. However, the efficacy and effectiveness of 3D-printed devices remain undetermined for the majority of medical fields. 3D-printed devices can play an important role in healthcare, but more rigorous and long-term assessments are needed to determine if 3D-printed devices are clinically relevant before they become part of standard clinical practice.


2018 ◽  
Vol 1 (Supplement) ◽  
pp. 40
Author(s):  
E. Liciu ◽  
B. Frumuşeanu ◽  
B.M. Popescu ◽  
D.C. Florea ◽  
L. Niculescu ◽  
...  

Abstract Introduction. Among the cases of malignant tumors, gathering 30% of them, the most frequent is the osteosarcoma. It occurs especially in children and young adults, the mean age being 14 years old. The treatment consists initially in neoadjuvant chemotherapy, followed by the surgical removal of the tumor. Due to aggressive malignant features (rapid increase in size, tendency to invade surrounding tissues, variable location), in multiple cases, the surgical treatment of osteosarcoma becomes a true challenge. Materials and methods. Nowadays, it is possible to create 3D printed models, by using CT and MRI, which are superior to the 3D graphical reconstructions. The 3D printing technique facilitates the production of these 1:1 scale printed models that faithfully embody the patient’s particular features concerning the anatomic pathology. The benefits gained from using such a modern tool allow the orthopedic surgeons to establish the measurements of a precise resection and to simulate the surgical maneuvers, as part of an elaborated modern surgical planning. Results. In this article, we presented the case of a 10-year-old patient diagnosed with femoral osteosarcoma and treated with neoadjuvant chemotherapy followed by GMRS surgical approach based on a preoperative planning involving a 3D printed model. This piece was used to provide precise information regarding the tumor, to allow preoperative measurements and a surgical simulation. Conclusion. The surgical accuracy can be increased by using a personalized preoperative planning based on a 3D printed model, leading to a lower rate of long/ short-term complications, recurrences, or metastases.


2021 ◽  
Author(s):  
Fuyang Chen ◽  
Chenyu Huang ◽  
chen ling ◽  
Jinming Zhou ◽  
Yufeng Wang ◽  
...  

Abstract Background: Tibial plateau fracture is one of the common intra-articular fractures in clinic. And its accurate classification and treatment is a difficult problem for orthopedic surgeons. Our research aims to investigate the application value of 3D printing in the classification and preoperative planning of complex tibial plateau fractures.Methods: 28 cases of complex tibial plateau fractures diagnosed and treated in our hospital from January, 2017 to January, 2019.01 were analyzed. Preoperative spiral CT scan was performed and then DICOM data were input into the computer. We use Mimics to process data. And 3D printing technology was applied to print the 3D model of fracture (1:1). Combined with the 3D printed model, the tibial plateau fractures were subdivided into seven types according to the geometric plane of the tibial plateau. The surgical approach was determined on the 3D printed model. And then simulated operations such as accurate reduction of fracture and selection of plate placement were performed.Results: The reconstructed 3D model of tibial plateau fracture can accurately reflect the direction of fracture components displacement and the degree of plateau collapse. Also, it can help with the preoperative reconstructive plan for the tibial plateau fracture. The intraoperative fracture details were basically the same as the 3D printed model. And The fracture surface of the tibial plateau of all 28 patients was well improved in terms of restoring the anatomical structure.Conclusion: 3D printing technology can be used to guide the classification and preoperative planning of complex tibial plateau fractures.


2019 ◽  
Vol 03 (03) ◽  
pp. 151-160
Author(s):  
Michael J. Mosca ◽  
Pablo Castañeda

AbstractUse of three-dimensional (3D) printed models for preoperative planning, patient-specific surgical guides, and implants in orthopaedic surgery is a burgeoning technology. It has not been established if 3D-printed models for preoperative planning are associated with improved clinical outcomes or if they are cost-effective for hip surgeries including total hip arthroplasty (THA), periacetabular osteotomy (PAO), proximal femoral osteotomy (PFO), and/or hip fractures. The purpose of this study was to conduct a systematic search and literature review to determine if preoperative planning for hip surgery using 3D-printed models was associated with improved intra- and postoperative outcomes. Specific aims were to determine the (1) types of applications and studies conducted, (2) types of 3D printing/materials used, (3) specific outcomes evaluated, (4) efficacy of 3D printing in planning for hip surgery, and (5) limitations of current research. The authors searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL, and PubMed from inception through July 2017. Original research publications were included if the primary purpose was to evaluate 3D-printed models' ability to assist with the planning of hip surgeries. Papers were excluded if they were reviews, abstracts, and not available in English, their models were not patient-specific, or their research did not evaluate surgery of the acetabulofemoral joint or pelvis. Of the 3,369 unique papers identified, 21 met inclusion criteria after full-text review. Among the included studies, six evaluated 3D printing in THA, seven in PAO/PFO, and eight in fracture repairs/reconstruction. The research included nine case reports, three case series, one retrospective uncontrolled study, six prospective uncontrolled studies, and two prospective controlled studies. 3D printed models resulted in: reduced intraoperative improvisation, operating room time, blood loss/transfusions, improved positioning of plates/screws/implants, clinical scores, measures of realignment, and functional status. Recent innovations in 3D printing are promising but unproven to improve clinical outcomes in hip surgeries due to limitations of published research. This may impact utilization and reimbursement of 3D-printed models in hip surgery. Studies of resource utilization, cost-effectiveness, and controlled trials with standardized methods and clinical outcomes of relevance are needed.


Biomolecules ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 884
Author(s):  
Ivan Lau ◽  
Ashu Gupta ◽  
Zhonghua Sun

Both three-dimensional (3D) printing and virtual reality (VR) are reported as being superior to the current visualization techniques in conveying more comprehensive visualization of congenital heart disease (CHD). However, little is known in terms of their clinical value in diagnostic assessment, medical education, and preoperative planning of CHD. This cross-sectional study aims to address these by involving 35 medical practitioners to subjectively evaluate VR visualization of four selected CHD cases in comparison with the corresponding 3D printed heart models (3DPHM). Six questionnaires were excluded due to incomplete sections, hence a total of 29 records were included for the analysis. The results showed both VR and 3D printed heart models were comparable in terms of the degree of realism. VR was perceived as more useful in medical education and preoperative planning compared to 3D printed heart models, although there was no significant difference in the ratings (p = 0.54 and 0.35, respectively). Twenty-one participants (72%) indicated both the VR and 3DPHM provided additional benefits compared to the conventional medical imaging visualizations. This study concludes the similar clinical value of both VR and 3DPHM in CHD, although further research is needed to involve more cardiac specialists for their views on the usefulness of these tools.


2021 ◽  
Author(s):  
Fuyang Chen ◽  
Chenyu Huang ◽  
Chen Ling ◽  
Jinming Zhou ◽  
Yufeng Wang ◽  
...  

Abstract Background: Tibial plateau fracture is one of the common intra-articular fractures in clinic. And its accurate classification and treatment is a difficult problem for orthopedic surgeons. Our research aims to investigate the application value of 3D printing in the classification and preoperative planning of complex tibial plateau fractures.Methods: 28 cases of complex tibial plateau fractures diagnosed and treated in our hospital from January, 2017 to January, 2019.01 were analyzed. Preoperative spiral CT scan was performed and then DICOM data were input into the computer. We use Mimics to process data. And 3D printing technology was applied to print the 3D model of fracture (1:1). Combined with the 3D printed model, the tibial plateau fractures were subdivided into seven types according to the geometric plane of the tibial plateau. The surgical approach was determined on the 3D printed model. And then simulated operations such as accurate reduction of fracture and selection of plate placement were performed.Results: The reconstructed 3D model of tibial plateau fracture can accurately reflect the direction of fracture components displacement and the degree of plateau collapse. Also, it can help with the preoperative reconstructive plan for the tibial plateau fracture. The intraoperative fracture details were basically the same as the 3D printed model. And The fracture surface of the tibial plateau of all 28 patients was well improved in terms of restoring the anatomical structure.Conclusion: 3D printing technology can be used to guide the classification and preoperative planning of complex tibial plateau fractures.


2019 ◽  
Vol 25 (2) ◽  
pp. 363-377 ◽  
Author(s):  
Asier Muguruza Blanco ◽  
Lucas Krauel ◽  
Felip Fenollosa Artés

Purpose The use of physical 3D models has been used in the industry for a while, fulfilling the function of prototypes in the majority of cases where the designers, engineers and manufacturers optimize their designs before taking them into production. In recent years, there has been an increasing number of reports on the use of 3D models in medicine for preoperative planning. In some highly complex surgeries, the possibility of using printed models to previously perform operations can be determining in the success of the surgery. With the aim of providing new functionalities to an anatomical 3D-printed models, in this paper, a cost-effective manufacturing process has been developed. A set of tradition of traditional techniques have been combined with 3D printing to provide a maximum geometrical freedom to the process. By the use of an electroluminescent set of functional paints, the tumours and vessels of the anatomical printed model have been highlighted, providing to this models the possibility to increase its interaction with the surgeon. These set of techniques has been used to increase the value added to the reproduced element and reducing the costs of the printed model, thus making it more accessible. Design/methodology/approach Successfully case in where the use of a low-cost 3D-printed anatomical model was used as a tool for preoperative planning for a complex oncological surgery. The said model of a 70-year-old female patient with hepatic metastases was functionalized with the aim of increasing the interaction with the surgeons. The analysis of the construction process of the anatomical model based on the 3D printing as a tool for their use in the medical field has been made, as well as its cost. Findings The use of 3D printing in the construction of anatomical models as preoperative tools is relatively new; however, the functionalization of these tools by using conductive and electroluminescent materials with the aim of increasing the interaction with it by the surgeons is a novelty. And, based on the DIY principles, it offers a geographical limitlessness, reducing its cost without losing the added value. Originality/value The process based on 3D printing presented in this paper allows to reproduce low-cost anatomical models by following a simple sequence of steps. It can be done by people with low qualification anywhere with only access to the internet and with the local costs. The interaction of these models with the surgeon based on touch and sight is much higher, adding a very significant value it, without increasing its cost.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Dereje Gobena Alemayehu ◽  
Zhi Zhang ◽  
Elena Tahir ◽  
Djovensky Gateau ◽  
Dang-Feng Zhang ◽  
...  

The applications of 3D printing technology in health care, particularly orthopedics, continue to broaden as the technology becomes more advanced, accessible, and affordable worldwide. 3D printed models of computed tomography (CT) and magnetic resonance image (MRI) scans can reproduce a replica of anatomical parts that enable surgeons to get a detailed understanding of the underlying anatomy that he/she experiences intraoperatively. The 3D printed anatomic models are particularly useful for preoperative planning, simulation of complex orthopedic procedures, development of patient-specific instruments, and implants that can be used intraoperatively. This paper reviews the role of 3D printing technology in orthopedic surgery, specifically focusing on the role it plays in assisting surgeons to have a better preoperative evaluation and surgical planning.


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