3D printing in spine surgery: current and future applications

2021 ◽  
Author(s):  
Umar F Samdani ◽  
Steven W Hwang
Keyword(s):  
3D Printing ◽  
Spine Surgery ◽  
3D Models ◽  
Patient Specific ◽  
Spine Deformity ◽  
Medical Field ◽  
The Us ◽  
Us Fda ◽  
Term Data

The revolutionary technology of 3D printing has gained traction in the medical field in recent years; spine surgery has in particular seen major advances in 3D printing. The applications of this technology have grown from utilizing 3D models to enhance patient education to patient specific, highly detailed intraoperative anatomical molds. However, obstacles remain that prevent the widespread utilization of 3D printing in spine surgery such as cost, time consumption, lack of long-term data, and regulation by the US FDA. Despite these obstacles, it is evident that 3D printing will be utilized to optimize preoperative, intraoperative, and postoperative care of patients with spine deformity. The purpose of this review is to establish the applications of 3D printing for spine surgery.

scholarly journals Accessing 3D Printed Vascular Phantoms for Procedural Simulation

2021 ◽  
Vol 7 ◽  
Author(s):  
Jasamine Coles-Black ◽  
Damien Bolton ◽  
Jason Chuen
Keyword(s):  
3D Printing ◽  
Endovascular Procedures ◽  
Low Cost ◽  
3D Models ◽  
Routine Care ◽  
Aortic Aneurysms ◽  
Patient Specific ◽  
Ct Angiogram ◽  
Abdominal Aortic ◽  
3D Printed

Introduction: 3D printed patient-specific vascular phantoms provide superior anatomical insights for simulating complex endovascular procedures. Currently, lack of exposure to the technology poses a barrier for adoption. We offer an accessible, low-cost guide to producing vascular anatomical models using routine CT angiography, open source software packages and a variety of 3D printing technologies.Methods: Although applicable to all vascular territories, we illustrate our methodology using Abdominal Aortic Aneurysms (AAAs) due to the strong interest in this area. CT aortograms acquired as part of routine care were converted to representative patient-specific 3D models, and then printed using a variety of 3D printing technologies to assess their material suitability as aortic phantoms. Depending on the technology, phantoms cost $20–$1,000 and were produced in 12–48 h. This technique was used to generate hollow 3D printed thoracoabdominal aortas visible under fluoroscopy.Results: 3D printed AAA phantoms were a valuable addition to standard CT angiogram reconstructions in the simulation of complex cases, such as short or very angulated necks, or for positioning fenestrations in juxtarenal aneurysms. Hollow flexible models were particularly useful for device selection and in planning of fenestrated EVAR. In addition, these models have demonstrated utility other settings, such as patient education and engagement, and trainee and anatomical education. Further study is required to establish a material with optimal cost, haptic and fluoroscopic fidelity.Conclusion: We share our experiences and methodology for developing inexpensive 3D printed vascular phantoms which despite material limitations, successfully mimic the procedural challenges encountered during live endovascular surgery. As the technology continues to improve, 3D printed vascular phantoms have the potential to disrupt how endovascular procedures are planned and taught.

scholarly journals Extended storage of SARS-CoV-2 nasopharyngeal swabs does not negatively impact results of molecular-based testing across three clinical platforms

2020 ◽  
pp. jclinpath-2020-206738
Author(s):  
Karin A Skalina ◽  
D Y Goldstein ◽  
Jaffar Sulail ◽  
Eunkyu Hahm ◽  
Momka Narlieva ◽  
...  
Keyword(s):  
Real World ◽  
Nasopharyngeal Swab ◽  
Molecular Testing ◽  
Clinical Tests ◽  
Ambient Conditions ◽  
Long Term Stability ◽  
The Us ◽  
Us Fda ◽  
World Environment

With the global outbreak of COVID-19, the demand for testing rapidly increased and quickly exceeded the testing capacities of many laboratories. Clinical tests which receive CE (Conformité Européenne) and Food and Drug Administration (FDA) authorisations cannot always be tested thoroughly in a real-world environment. Here we demonstrate the long-term stability of nasopharyngeal swab specimens for SARS-CoV-2 molecular testing across three assays recently approved by the US FDA under Emergency Use Authorization. This study demonstrates that nasopharyngeal swab specimens can be stored under refrigeration or even ambient conditions for 21 days without clinically impacting the results of the real-time reverse transcriptase-PCR testing.

Digital Design and 3D Printing of Aortic Arch Reconstruction in HLHS for Surgical Simulation and Training

2018 ◽  
Vol 9 (4) ◽  
pp. 454-458 ◽  
Author(s):  
Sarah A. Chen ◽  
Chin Siang Ong ◽  
Nagina Malguria ◽  
Luca A. Vricella ◽  
Juan R. Garcia ◽  
...  
Keyword(s):  
3D Printing ◽  
Aortic Arch ◽  
Surgical Simulation ◽  
Three Dimensional ◽  
3D Models ◽  
Digital Design ◽  
Patient Specific ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction ◽  
And Training

Purpose: Patients with hypoplastic left heart syndrome (HLHS) present a diverse spectrum of aortic arch morphology. Suboptimal geometry of the reconstructed aortic arch may result from inappropriate size and shape of an implanted patch and may be associated with poor outcomes. Meanwhile, advances in diagnostic imaging, computer-aided design, and three-dimensional (3D) printing technology have enabled the creation of 3D models. The purpose of this study is to create a surgical simulation and training model for aortic arch reconstruction. Description: Specialized segmentation software was used to isolate aortic arch anatomy from HLHS computed tomography scan images to create digital 3D models. Three-dimensional modeling software was used to modify the exported segmented models and digitally design printable customized patches that were optimally sized for arch reconstruction. Evaluation: Life-sized models of HLHS aortic arch anatomy and a digitally derived customized patch were 3D printed to allow simulation of surgical suturing and reconstruction. The patient-specific customized patch was successfully used for surgical simulation. Conclusions: Feasibility of digital design and 3D printing of patient-specific patches for aortic arch reconstruction has been demonstrated. The technology facilitates surgical simulation. Surgical training that leads to an understanding of optimal aortic patch geometry is one element that may potentially influence outcomes for patients with HLHS.

scholarly journals The Value of 3D Printing Models of Left Atrial Appendage Using Real-Time 3D Transesophageal Echocardiographic Data in Left Atrial Appendage Occlusion: Applications toward an Era of Truly Personalized Medicine

Cardiology ◽  
2016 ◽  
Vol 135 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Peng Liu ◽  
Rijing Liu ◽  
Yan Zhang ◽  
Yingfeng Liu ◽  
Xiaoming Tang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
3D Printing ◽  
Real Time ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
3D Models ◽  
Atrial Appendage ◽  
Patient Specific ◽  
The Real ◽  
Echocardiographic Image

Aims and Objectives: The objective of this study was to assess the clinical feasibility of generating 3D printing models of left atrial appendage (LAA) using real-time 3D transesophageal echocardiogram (TEE) data for preoperative reference of LAA occlusion. Background: Percutaneous LAA occlusion can effectively prevent patients with atrial fibrillation from stroke. However, the anatomical structure of LAA is so complicated that adequate information of its structure is essential for successful LAA occlusion. Emerging 3D printing technology has the demonstrated potential to structure more accurately than conventional imaging modalities by creating tangible patient-specific models. Typically, 3D printing data sets are acquired from CT and MRI, which may involve intravenous contrast, sedation, and ionizing radiation. It has been reported that 3D models of LAA were successfully created by the data acquired from CT. However, 3D printing of the LAA using real-time 3D TEE data has not yet been explored. Methods: Acquisition of 3D transesophageal echocardiographic data from 8 patients with atrial fibrillation was performed using the Philips EPIQ7 ultrasound system. Raw echocardiographic image data were opened in Philips QLAB and converted to ‘Cartesian DICOM' format and imported into Mimics® software to create 3D models of LAA, which were printed using a rubber-like material. The printed 3D models were then used for preoperative reference and procedural simulation in LAA occlusion. Results: We successfully printed LAAs of 8 patients. Each LAA costs approximately CNY 800-1,000 and the total process takes 16-17 h. Seven of the 8 Watchman devices predicted by preprocedural 2D TEE images were of the same sizes as those placed in the real operation. Interestingly, 3D printing models were highly reflective of the shape and size of LAAs, and all device sizes predicted by the 3D printing model were fully consistent with those placed in the real operation. Also, the 3D printed model could predict operating difficulty and the presence of a peridevice leak. Conclusions: 3D printing of the LAA using real-time 3D transesophageal echocardiographic data has a perfect and rapid application in LAA occlusion to assist with physician planning and decision making.

scholarly journals Estimated Cancer Risks Associated with Nitrosamine Contamination in Commonly Used Medications

2021 ◽  
Vol 18 (18) ◽  
pp. 9465
Author(s):  
Kate Li ◽  
Karin Ricker ◽  
Feng C. Tsai ◽  
ChingYi J. Hsieh ◽  
Gwendolyn Osborne ◽  
...  
Keyword(s):  
Environmental Protection Agency ◽  
Animal Species ◽  
Protection Agency ◽  
Cancer Risks ◽  
The Us ◽  
Treatment Of Hypertension ◽  
Us Fda

Many nitrosamines are potent carcinogens, with more than 30 listed under California’s Proposition 65. Recently, nitrosamine contamination of commonly used drugs for treatment of hypertension, heartburn, and type 2 diabetes has prompted numerous Food and Drug Administration (FDA) recalls in the US. These contaminants include the carcinogens NDMA (N-nitrosodimethylamine) and NDEA (N-nitrosodiethylamine) and the animal tumorigen NMBA (N-nitroso-N-methyl-4-aminobutyric acid). NMBA and NDEA are metabolically and/or structurally related to NDMA, an N-nitrosomethyl-n-alkylamine (NMA), and 12 other carcinogenic NMAs. These nitrosamines exhibit common genotoxic and tumorigenic activities, with shared target tumor sites amongst chemicals and within a given laboratory animal species. We use the drug valsartan as a case study to estimate the additional cancer risks associated with NDMA and NDEA contamination, based on nitrosamine levels reported by the US FDA, cancer potencies developed by California’s Proposition 65 program and the US Environmental Protection Agency (EPA), and specific exposure scenarios. These estimates suggest that nitrosamine contamination in drugs that are used long-term can increase cancer risks and pose a serious concern to public health.

scholarly journals Three-dimensional printing in adult cardiovascular medicine for surgical and transcatheter procedural planning, teaching and technological innovation

2019 ◽  
Author(s):  
Enrico Ferrari ◽  
Michele Gallo ◽  
Changtian Wang ◽  
Lei Zhang ◽  
Maurizio Taramasso ◽  
...  
Keyword(s):  
3D Printing ◽  
Cardiac Imaging ◽  
Three Dimensional ◽  
3D Models ◽  
Patient Specific ◽  
Digital Information ◽  
Widespread Application ◽  
Mitral Valves ◽  
Materials Used ◽  
Procedural Planning

Abstract Three-dimensional (3D)-printing technologies in cardiovascular surgery have provided a new way to tailor surgical and percutaneous treatments. Digital information from standard cardiac imaging is integrated into physical 3D models for an accurate spatial visualization of anatomical details. We reviewed the available literature and analysed the different printing technologies, the required procedural steps for 3D prototyping, the used cardiac imaging, the available materials and the clinical implications. We have highlighted different materials used to replicate aortic and mitral valves, vessels and myocardial properties. 3D printing allows a heuristic approach to investigate complex cardiovascular diseases, and it is a unique patient-specific technology providing enhanced understanding and tactile representation of cardiovascular anatomies for the procedural planning and decision-making process. 3D printing may also be used for medical education and surgical/transcatheter training. Communication between doctors and patients can also benefit from 3D models by improving the patient understanding of pathologies. Furthermore, medical device development and testing can be performed with rapid 3D prototyping. Additionally, widespread application of 3D printing in the cardiovascular field combined with tissue engineering will pave the way to 3D-bioprinted tissues for regenerative medicinal applications and 3D-printed organs.

scholarly journals The Role of 3D Printing in Medical Applications: A State of the Art

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Anna Aimar ◽  
Augusto Palermo ◽  
Bernardo Innocenti
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Patient Specific ◽  
Digital Information ◽  
Medical Implants ◽  
Medical Field ◽  
3D Printed ◽  
Pipe Dream ◽  
Manufacturing Technologies

Three-dimensional (3D) printing refers to a number of manufacturing technologies that generate a physical model from digital information. Medical 3D printing was once an ambitious pipe dream. However, time and investment made it real. Nowadays, the 3D printing technology represents a big opportunity to help pharmaceutical and medical companies to create more specific drugs, enabling a rapid production of medical implants, and changing the way that doctors and surgeons plan procedures. Patient-specific 3D-printed anatomical models are becoming increasingly useful tools in today’s practice of precision medicine and for personalized treatments. In the future, 3D-printed implantable organs will probably be available, reducing the waiting lists and increasing the number of lives saved. Additive manufacturing for healthcare is still very much a work in progress, but it is already applied in many different ways in medical field that, already reeling under immense pressure with regards to optimal performance and reduced costs, will stand to gain unprecedented benefits from this good-as-gold technology. The goal of this analysis is to demonstrate by a deep research of the 3D-printing applications in medical field the usefulness and drawbacks and how powerful technology it is.

Long-Term Treatment Effect and Predictability of Spinopelvic Alignment After Surgical Correction of Adult Spine Deformity With Patient-Specific Spine Rods

Spine ◽  
2020 ◽  
Vol 45 (7) ◽  
pp. E387-E396 ◽  
Author(s):  
Christopher J. Kleck ◽  
David Calabrese ◽  
Bradley J. Reeves ◽  
Christopher M.J. Cain ◽  
Vikas V. Patel ◽  
...  
Keyword(s):  
Treatment Effect ◽  
Term Treatment ◽  
Surgical Correction ◽  
Patient Specific ◽  
Spine Deformity ◽  
Adult Spine Deformity ◽  
Spinopelvic Alignment ◽  
Long Term Treatment ◽  
Adult Spine

scholarly journals A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Teresa E. Flaxman ◽  
Carly M. Cooke ◽  
Olivier X. Miguel ◽  
Adnan M. Sheikh ◽  
Sukhbir S. Singh
Keyword(s):  
3D Printing ◽  
Clinical Benefit ◽  
Three Dimensional ◽  
Uterine Fibroids ◽  
3D Models ◽  
Gynecologic Surgery ◽  
Patient Specific ◽  
Mr Images ◽  
Adjacent Structures ◽  
3D Printed

Abstract Background Patient specific three-dimensional (3D) models can be derived from two-dimensional medical images, such as magnetic resonance (MR) images. 3D models have been shown to improve anatomical comprehension by providing more accurate assessments of anatomical volumes and better perspectives of structural orientations relative to adjacent structures. The clinical benefit of using patient specific 3D printed models have been highlighted in the fields of orthopaedics, cardiothoracics, and neurosurgery for the purpose of pre-surgical planning. However, reports on the clinical use of 3D printed models in the field of gynecology are limited. Main text This article aims to provide a brief overview of the principles of 3D printing and the steps required to derive patient-specific, anatomically accurate 3D printed models of gynecologic anatomy from MR images. Examples of 3D printed models for uterine fibroids and endometriosis are presented as well as a discussion on the barriers to clinical uptake and the future directions for 3D printing in the field of gynecological surgery. Conclusion Successful gynecologic surgery requires a thorough understanding of the patient’s anatomy and burden of disease. Future use of patient specific 3D printed models is encouraged so the clinical benefit can be better understood and evidence to support their use in standard of care can be provided.

scholarly journals Opinion Piece: Patient-Specific Implants May Be the Next Big Thing in Spinal Surgery

2021 ◽  
Vol 11 (6) ◽  
pp. 498
Author(s):  
Tajrian Amin ◽  
William C.H. Parr ◽  
Ralph J. Mobbs
Keyword(s):  
Spinal Surgery ◽  
Patient Specific ◽  
Surgical Workflow ◽  
Patient Specific Implants ◽  
Potential Benefits ◽  
Improve Patient ◽  
Term Data ◽  
Key Questions

The emergence of 3D-Printing technologies and subsequent medical applications have allowed for the development of Patient-specific implants (PSIs). There have been increasing reports of PSI application to spinal surgery over the last 5 years, including throughout the spine and to a range of pathologies, though largely for complex cases. Through a number of potential benefits, including improvements to the implant–bone interface and surgical workflow, PSIs aim to improve patient and surgical outcomes, as well as potentially provide new avenues for combating challenges routinely faced by spinal surgeons. However, obstacles to widespread acceptance and routine application include the lack of quality long-term data, research challenges and the practicalities of production and navigating the regulatory environment. While recognition of the significant potential of Spinal PSIs is evident in the literature, it is clear a number of key questions must be answered to inform future clinical and research practices. The spinal surgical community must selectively and ethically continue to offer PSIs to patients, simultaneously allowing for the necessary larger, comparative studies to be conducted, as well as continuing to provide optimal patient care, thereby ultimately determining the exact role of this technology and potentially improving outcomes.

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