Use of a three-dimensional printed anatomical model for tumor management in a pediatric patient

Salazar, David; Huff, Trevor; Cramer, Justin A.; Wong, Lincoln; Linke, Gabe; Zúñiga, Jorge M.

doi:10.1177/2050313x20927600

Cited by 9 publications

(4 citation statements)

References 12 publications

(13 reference statements)

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“…In line with our observations, it has been shown recently that preoperative planning with 3D modeling and printing can improve the accuracy of screw positioning and provide an improved sense of spinal anatomy [6], especially in the treatment of spinal deformity in children [7]. Even though most papers address the value of 3D-printed models for anatomical considerations [6,7,[17][18][19], they do not explore the full potential of preoperative in vitro testing. Our case shows that testing on a 3D-printed model in vitro not only improves visualization and the sense of spinal anatomy and screw positioning but also offers additional opportunities to find the best surgical solutions and test the feasibility of fixation in the pediatric spine preoperatively, thereby reducing intraoperative complications, especially in the absence of intraoperative navigation.…”

Section: Discussionsupporting

confidence: 54%

A 3D-Printed Model-Assisted Cervical Spine Instrumentation after Tumor Resection in a 4-Year-Old Child: A Case Report

Jug

2021

Pediatr Neurosurg

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Introduction: In the case of tumor resection in the upper cervical spine, a multilevel laminectomy with instrumented fixation is required to prevent kyphotic deformity and myelopathy. Nevertheless, instrumentation of the cervical spine in children under the age of 8 years is challenging due to anatomical considerations and unavailability of specific instrumentation. Case Presentation: We present a case of 3D-printed model-assisted cervical spine instrumentation in a 4-year-old child with post-laminectomy kyphotic decompensation of the cervical spine and spinal cord injury 1 year after medulloblastoma metastasis resection in the upper cervical spine. Due to unavailability of specific instrumentation, 3D virtual planning was used to assess and plan posterior cervical fixation. Fixation with 3.5 mm lateral mass and isthmic screws was suggested and the feasibility of fixation was confirmed “in vitro” in a 3D-printed model preoperatively to reduce the possibility of intraoperative implant-spine mismatch. Intraoperative conditions completely resembled the preoperative plan and 3.5 mm polyaxial screws were successfully used as planned. Postoperatively the child made a complete neurological recovery and 2 years after the instrumented fusion is still disease free with no signs of spinal decompensation. Discussion/Conclusion: Our case shows that posterior cervical fixation with the conventional screw-rod technique in a 4-year-old child is feasible, but we suggest that suitability and positioning of the chosen implants are preoperatively assessed in a printed 3D model. In addition, a printed 3D model offers the possibility to better visualize and sense spinal anatomy “in vivo,” thereby helping screw placement and reducing the chance for intraoperative complications, especially in the absence of intraoperative spinal navigation.

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Section: Discussionsupporting

confidence: 54%

A 3D-Printed Model-Assisted Cervical Spine Instrumentation after Tumor Resection in a 4-Year-Old Child: A Case Report

Jug

2021

Pediatr Neurosurg

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“…Of these, 20 were excluded, and only 10 studies were eligible for full-text review. Two of these were further excluded, as these focused on juvenile ossifying fibroma of the jaw and tumor involving the cervical spine [ 10 , 11 ]. Finally, eight were included in the systematic review ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Utility of Three-Dimensional Printing for Preoperative Assessment of Children with Extra-Cranial Solid Tumors: A Systematic Review

et al. 2022

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Background: In cases with solid tumors, preoperative radiological investigations provide valuable information on the anatomy of the tumor and the adjoining structures, thus helping in operative planning. However, due to a two-dimensional view in these investigations, a detailed spatial relationship is difficult to decipher. In contrast, three-dimensional (3D) printing technology provides a precise topographic view to perform safe surgical resections of these tumors. This systematic review aimed to summarize and analyze current evidence on the utility of 3D printing in pediatric extra-cranial solid tumors. Methods: The present study was registered on PROSPERO—international prospective register of systematic reviews (registration number: CRD42020206022). PubMed, Embase, SCOPUS, and Google Scholar databases were explored with appropriate search criteria to select the relevant studies. Data were extracted to study the bibliographic information of each article, the number of patients in each study, age of the patient(s), type of tumor, organ of involvement, application of 3D printing (surgical planning, training, and/or parental education). The details of 3D printing, such as type of imaging used, software details, printing technique, printing material, and cost were also synthesized. Results: Eight studies were finally included in the systematic review. Three-dimensional printing technology was used in thirty children with Wilms tumor (n = 13), neuroblastoma (n = 7), hepatic tumors (n = 8), retroperitoneal tumor (n = 1), and synovial sarcoma (n = 1). Among the included studies, the technology was utilized for preoperative surgical planning (five studies), improved understanding of the surgical anatomy of solid organs (two studies), and improving the parental understanding of the tumor and its management (one study). Computed tomography and magnetic resonance imaging were either performed alone or in combination for radiological evaluation in these children. Different types of printers and printing materials were used in the included studies. The cost of the 3D printed models and time involved (range 10 h to 4–5 days) were reported by two studies each. Conclusions: 3D printed models can be of great assistance to pediatric surgeons in understanding the spatial relationships of tumors with the adjacent anatomic structures. They also facilitate the understanding of families, improving doctor–patient communication.

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“…Multi-material 3D prototypes are a better approach for the production of oncological anatomical models, in comparison with mono-material 3D technologies. Having different materials, with different mechanical properties and colors in the prototypes, makes each part easier to highlight and differentiate [21]. Following the presented strategies, this is not accomplished in the case of SLA technology, in which the need for a unique resin tank limits the ability to produce multi-material models in just one print.…”

Section: Properties and Applicationsmentioning

confidence: 99%

Advanced Strategies for the Fabrication of Multi-Material Anatomical Models of Complex Pediatric Oncologic Cases

Valls-Esteve,

Tejo-Otero,

Adell-Gómez

et al. 2023

Bioengineering

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The printing and manufacturing of anatomical 3D models has gained popularity in complex surgical cases for surgical planning, simulation and training, the evaluation of anatomical relations, medical device testing and patient–professional communication. 3D models provide the haptic feedback that Virtual or Augmented Reality (VR/AR) cannot provide. However, there are many technologies and strategies for the production of 3D models. Therefore, the aim of the present study is to show and compare eight different strategies for the manufacture of surgical planning and training prototypes. The eight strategies for creating complex abdominal oncological anatomical models, based on eight common pediatric oncological cases, were developed using four common technologies (stereolithography (SLA), selectie laser sinterning (SLS), fused filament fabrication (FFF) and material jetting (MJ)) along with indirect and hybrid 3D printing methods. Nine materials were selected for their properties, with the final models assessed for application suitability, production time, viscoelastic mechanical properties (shore hardness and elastic modulus) and cost. The manufacturing and post-processing of each strategy is assessed, with times ranging from 12 h (FFF) to 61 h (hybridization of FFF and SLS), as labor times differ significantly. Cost per model variation is also significant, ranging from EUR 80 (FFF) to EUR 600 (MJ). The main limitation is the mimicry of physiological properties. Viscoelastic properties and the combination of materials, colors and textures are also substantially different according to the strategy and the intended use. It was concluded that MJ is the best overall option, although its use in hospitals is limited due to its cost. Consequently, indirect 3D printing could be a solid and cheaper alternative.

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Use of a three-dimensional printed anatomical model for tumor management in a pediatric patient

Cited by 9 publications

References 12 publications

A 3D-Printed Model-Assisted Cervical Spine Instrumentation after Tumor Resection in a 4-Year-Old Child: A Case Report

A 3D-Printed Model-Assisted Cervical Spine Instrumentation after Tumor Resection in a 4-Year-Old Child: A Case Report

Utility of Three-Dimensional Printing for Preoperative Assessment of Children with Extra-Cranial Solid Tumors: A Systematic Review

Advanced Strategies for the Fabrication of Multi-Material Anatomical Models of Complex Pediatric Oncologic Cases

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