3D printed composite model of pelvic osteochondroma and nerve roots

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.

Three-Dimensional Printing in Spinal Surgery: Current Uses

“…Fox and Kanawati29 also created a 3D-printed spine model to facilitate surgical planning before tumor surgery and showed that it could enhance precision and safety (Figure 2). Although preoperative planning with RP may appear to entail greater financial burden, the subsequent likelihood of increased patient-specific anatomical knowledge, decreased operative time and blood loss, improved screw insertion accuracy, and recognition of aberrant anatomy not discernible on 2D imaging likely outweigh initial costs, providing strong evidence in favor of its use in spinal surgery 1,2,27,28,30.…”