Three spine surgeons weigh in on what they hope to see in 3D spine instrumentation printing in the near future.
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Question: What advances do you hope to see in 3D printing in the next five to 10 years?
Mark M. Mikhael, MD. Spine Surgeon at NorthShore University HealthSystem's Orthopaedic Institute and Illinois Bone & Joint Institute (Chicago & Glenview, Ill.): I would like 3D printing to advance to shaping implants that are customized, better suited for different body types and sizes and various pathologies. Most people don't fall into the standard small, medium and large sizes. Also, as we learn to better utilize 3D printing with different kinds of materials, I would like to use more than metal implants — more biologically compatible materials. There is promising research with implants that "on-growth" and "in-growth" into bone. They are made from porous materials and different biologics, such as calcium phosphate ceramic and hydroxyapatite, as examples. I hope we find a better way to bond implants to bone. It will only benefit the patient and result in improved long-term outcomes.
Issada Thongtrangan, MD. Orthopedic Spine and Neurosurgeon at Minimally Invasive Spine (Phoenix): I see the future of 3D printing in complex spine cases, such as a congenital deformity, severe spinal degeneration or destruction of the spine from a tumor. These issues are difficult or impossible to reconstruct with an off-the-shelf implant.
The main benefit of 3D spinal implants is that we can print a unique implant that is specifically designed to fit perfectly into a defect to correct a problem. In addition, there is currently research being performed on 3D printing of artificial discs.
I would like to see the clinical outcomes data to justify this technology due to their cost.
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: This area has been seemingly quiescent, in my opinion. I am hoping that newer coatings on implants and highly detailed surfaces have some promise. Peer-reviewed, nonsponsored papers will bear out how much better [they will be]. This will dictate physician adoption. But custom implants are still expensive and represent a lot of cost. If the payers see value, they will flourish. If not, they will be another sad footnote in good but aborted technology.