Evaluating the Utility of 3D Printing for Planning and Education in Spinal Surgery

Introduction: One of the major developments within spinal neurosurgery is the implementation of 3D printing technology. This study aims to evaluate the utility of 3D printing in the development of a surgical plan and education of patients.

Methods: A systematic review of the literature using PubMed, Google Scholar, and Web of Science electronic databases was completed according to the PRISMA guidelines identifying studies discussing the usage of 3-D printing for planning and education.

Results: 80 articles met inclusion criteria: 45 case reports/series, discussing 136 cases and 35 retrospective studies (n=880). Of the 136 patients with an average age of 44.51±17.72 years, 66 were male (48.53%), 65 were female (47.8%), while 5 (3.7%) cases did not report gender. In terms of the utilization of 3-D printing, all 80 studies indicated positive findings associated with the use of 3D printing for planning and/or education. Intraoperative improvements consisted of reduced operation time, intraoperative error, blood loss, as well as better fit of implants and screws, reducing postoperative complications with no complications in 28 of 37 patients (75.7%). Further, one study reported 268.4±42.7 mL of blood loss with 3D printing compared to 347.8±52.2 mL in a control group. 3-D printing displayed improved patient outcomes with only 1 patient (1.7%) developing worsened neurologic symptoms while 56 (94.9%) had improved neurologic conditions postoperatively. The main perioperative drawbacks of 3D printing involve a delay in operations and increased total cost of the operation related to model development and equipment required.

Conclusion : While 3D printing is a relatively new development in the field of neurosurgery, implementation of the tool in the preoperative planning and education surrounding complex spinal surgeries was demonstrated to have great benefits in intraoperative characteristics as well as patient outcomes.