Three spine surgeons weigh in on the advantages and disadvantages of 3D-printed spinal devices.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.
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Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Aug. 29, at 5 p.m. CST.
Question: What are the pros and cons of 3D-printed devices and tools?
Mark M. Mikhael, MD. Spine Surgeon at NorthShore University HealthSystem's Orthopaedic Institute and Illinois Bone & Joint Institute (Chicago & Glenview, Ill.): The pros are you get make customized tools or implants, and you may get greater access or view to certain areas of the spine because of the 3D view. The cons are the delay in getting the devices — a surgeon might need them quickly to address a patient's immediate needs. Also, there is an increased cost with the technology and unknown benefits.
Right now, there are no long-term studies that show the utility of 3D modeling in the spine. It's unclear in current research, especially in adults with spinal deformities. However, 3D printing used in preoperative planning is showing great promise for pediatric spinal deformity, especially preoperative planning for congenital deformities.
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: The advent of 3D-printed devices has captured the imagination of physicians and medical engineers alike. The idea of custom-creating a perfect, personalized device is now a possibility. What we have not seen is the widespread availability of such devices. While in the neurosurgical sphere, custom-made skull implants have been around for decades, parity in spine remained delayed. Perhaps the cost of the software or electronic "forges" has been prohibitive. Many other areas of industry have found a lot of interest in 3D printing. My hope is that in the future, instead of 3D-printed guns, we can work more on 3D-printed vertebral replacements.
Payam Farjoodi, MD. Orthopedic Spine Surgeon at Spine Health Center at MemorialCare Orange Coast Medical Center (Fountain Valley, Calif.): This exciting technology allows patients to have a surgery that is tailor fit for their specific [needs]. By using preoperative imaging, the surgeon has the ability to pick the ideal implant for that particular spine rather than [being] forced to use a "one size fits all" approach. The biggest negative, as of now, is the availability of these devices and the ease with which to plan and obtain them. As 3D printing evolves, a local or on-site printer may reduce these difficulties.