Titanium Patient-Specific Implants in Reconstructive Neurosurgery

Мишинов, С. В.; Stupak, V. V.; Копорушко, Николай Александрович; Samokhin, A. G.; Panchenko, Alexander; Krasovskii, I. B.; Desyatykh, I. V.; Kiselev, A. S.

doi:10.1007/s10527-018-9802-3

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…Оригинальная работа | Original report имплантов, созданных при помощи компьютерного моделирования, является наиболее перспективным направлением в нейрохирургии и челюстно-лицевой хирургии [14][15][16][17]. Оптимальные функциональные и косметические результаты делают данную технологию наиболее предпочтительным методом в клинической практике по сравнению с традиционным подходом, основанным на интраоперационном моделировании импланта.…”

Section: Russian Journal Of Neurosurgeryunclassified

Resection of tumors of the cranial bones with single-step defect reconstruction using a personalized implant

Yashin,

Zinatullin,

Bratsev

et al. 2024

Nejrohirurgiâ (Mosk.)

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Background. In patients with skull bone tumors, it was demonstrated that not only the oncological but also the cosmetic result has a significant influence on the long-term outcome. The traditional approach to the surgical treatment of tumor lesions of the skull bones is removal of the tumor and intraoperative modeling an artificial bone flap without a template. Recently, the technology of simultaneous resection and computer-aided design/computer-aided manufacturing (CAD/CAM) cranioplasty has received more and more attention.Aim. To compare the results of surgical treatment of patients with tumors of the cranial bones using the traditional approach (intraoperative formation of a plate to close the defect) and simultaneous resection followed by plastic surgery of the defect with a personalized implant made using preoperative virtual modeling.Materials and methods. The study included 24 patients with tumors of the skull or meningiomas with extracranial growth. Depending on the surgical procedure, patients were divided into 2 groups: group 1 (n = 13) – the technology of simultaneous resection and CAD/CAM cranioplasty; group 2 (n = 11) – where surgery was performed using a traditional approach based on intraoperative modeling an artificial bone flap without a template.Results. There were no statistically significant differences between groups in gender, age, time of surgery, blood loss, or time in hospital. The use of simultaneous resection and CAD/CAM cranioplasty did not demonstrate a statistically significant better result in terms of maintaining skull symmetry compared to the traditional approach. All patients had a good cosmetic result and there were no complications.Conclusion. The technology of simultaneous resection and CAD/CAM cranioplasty is an effective method of treating patients with neoplasmas of the skull bones. Despite the absence of statistically significant differences in the results of treatment of cranial bone tumors between this method and the traditional approach based on intraoperative modeling an artificial bone flap without a template this method seems to be a more precise providing the best cosmetic effect in patients with lesion in fronto-orbital region.

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Section: Russian Journal Of Neurosurgeryunclassified

Resection of tumors of the cranial bones with single-step defect reconstruction using a personalized implant

Yashin,

Zinatullin,

Bratsev

et al. 2024

Nejrohirurgiâ (Mosk.)

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“…Orthopedic cases often require degradable, patientspecific solutions rather than simply the purely mechanical replacement that titanium implants offer [9]. With the aid of additive manufacturing and 3D printing techniques, different material classes can play an additional role here [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

3D printing of patient-specific implants for osteochondral defects: workflow for an MRI-guided zonal design

et al. 2021

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Magnetic resonance imaging (MRI) is a common clinical practice to visualize defects and to distinguish different tissue types and pathologies in the human body. So far, MRI data have not been used to model and generate a patient-specific design of multilayered tissue substitutes in the case of interfacial defects. For orthopedic cases that require highly individual surgical treatment, implant fabrication by additive manufacturing holds great potential. Extrusion-based techniques like 3D plotting allow the spatially defined application of several materials, as well as implementation of bioprinting strategies. With the example of a typical multi-zonal osteochondral defect in an osteochondritis dissecans (OCD) patient, this study aimed to close the technological gap between MRI analysis and the additive manufacturing process of an implant based on different biomaterial inks. A workflow was developed which covers the processing steps of MRI-based defect identification, segmentation, modeling, implant design adjustment, and implant generation. A model implant was fabricated based on two biomaterial inks with clinically relevant properties that would allow for bioprinting, the direct embedding of a patient’s own cells in the printing process. As demonstrated by the geometric compatibility of the designed and fabricated model implant in a stereolithography (SLA) model of lesioned femoral condyles, a novel versatile CAD/CAM workflow was successfully established that opens up new perspectives for the treatment of multi-zonal (osteochondral) defects. Graphic abstract

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“…[2][3][4] Therefore, optimum reconstruction should be chosen for every patient to achieve an ideal postoperative outcome. 5,6 The ideal material used for cranioplasty should have the following properties; biocompatibility, low cost, malleability to fit different defect shapes, and resistance to infection. Multiple materials have been used for that purpose with different pros and cons.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of three different methods of cranioplasty; a comparative prospective randomized study

Mousa

Eissa

Raslan

et al. 2021

Pan Arab Journal of Neurosurgery

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BACKGROUND: Multiple materials have been used for cranioplasty with different pros and cons. The current literature is defective in studies comparing titanium mesh, polyetheretherketone (PEEK), and polymethyl methacrylate (PMMA).OBJECT: This prospective randomized study was conducted to compare the outcomes of three cranioplasty techniques; titanium mesh, PEEK, and PMMA, regarding the failure rates, the complications, and the patients' satisfaction. METHODS:A total of 84 cases were included, and they were randomly divided into three groups (28 cases in each group); titanium mesh, PEEK, and PMMA groups. All patients underwent proper preoperative evaluation, including history taking, neurological examination, and routine investigations. The operative time and postoperative complications were recorded. Our primary outcome was implant failure rates, whereas secondary outcomes included implant exposure, surgical site infection, graft resorption, postoperative new-onset seizures, extradural hemorrhage, and patient satisfaction.RESULTS: Age, gender, indication for cranioplasty, and operative time did not show any significant differences between the three groups. The prevalence of implant failure was 10.7%, 3.6%, and 14.3% in the titanium mesh, PEEK and PMMA groups, respectively. Although all complications (apart from extradural hemorrhage) tended to have a higher prevalence in the PMMA group, no significant difference was detected between the three groups regarding these complications. However, this lead to a significant decrease in patients' satisfaction in the PMMA group. CONCLUSION: Titanium mesh, PEEK, and PMMA have a comparable complication profile when used for cranioplasty. However, complication rates showed a slight increase with PMMA, which lead to decreased patient satisfaction.

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Titanium Patient-Specific Implants in Reconstructive Neurosurgery

Cited by 7 publications

References 9 publications

Resection of tumors of the cranial bones with single-step defect reconstruction using a personalized implant

Resection of tumors of the cranial bones with single-step defect reconstruction using a personalized implant

3D printing of patient-specific implants for osteochondral defects: workflow for an MRI-guided zonal design

Evaluation of three different methods of cranioplasty; a comparative prospective randomized study

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