Rapid high-fidelity contour shaping of titanium mesh implants for cranioplasty defects using patient-specific molds created with low-cost 3D printing: A case series.

3D printing Cranioplasty Custom Polyether ether ketone Surgical economics Titanium

Journal

Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836

Informations de publication

Date de publication:
2020
Historique:
received: 30 07 2020
accepted: 28 08 2020
entrez: 9 10 2020
pubmed: 10 10 2020
medline: 10 10 2020
Statut: epublish

Résumé

Cranioplasty is a neurosurgical procedure to repair skull defects. Sometimes, the patients' bone flap cannot be used for various reasons. Alternatives include a custom polyether ether ketone (PEEK) implant or titanium mesh; both incur an additional cost. We present a technique that uses a 3D printer to create a patient- specific 3D model used to mold a titanium mesh preoperatively. We included three patients whose bone flap could not be used. We collected the patients' demographics, cost, and time data for implants and the 3D printer. The patients' computed tomography DICOM images were used for 3D reconstruction of the cranial defect. A 3D printer (Flashforge, CA) was used to print a custom mold of the defect, which was used to shape the titanium mesh. All patients had excellent cosmetic results with no complications. The time required to print a 3D model was ~ 6 h and 45 min for preoperative shaping of the titanium implant. The intraoperative molding (IOM) of a titanium mesh needed an average of 60 min additional operative room time which incurred $4000. The average cost for PEEK and flat titanium mesh is $12,600 and $6750. Our method resulted in $4000 and $5500 cost reduction in comparison to flat mesh with IOM and PEEK implant. 3D printing technology can create a custom model to shape a titanium mesh preoperatively for cranioplasty. It can result in excellent cosmetic results and significant cost reduction in comparison to other cranioplasty options.

Sections du résumé

BACKGROUND BACKGROUND
Cranioplasty is a neurosurgical procedure to repair skull defects. Sometimes, the patients' bone flap cannot be used for various reasons. Alternatives include a custom polyether ether ketone (PEEK) implant or titanium mesh; both incur an additional cost. We present a technique that uses a 3D printer to create a patient- specific 3D model used to mold a titanium mesh preoperatively.
CASE DESCRIPTION METHODS
We included three patients whose bone flap could not be used. We collected the patients' demographics, cost, and time data for implants and the 3D printer. The patients' computed tomography DICOM images were used for 3D reconstruction of the cranial defect. A 3D printer (Flashforge, CA) was used to print a custom mold of the defect, which was used to shape the titanium mesh. All patients had excellent cosmetic results with no complications. The time required to print a 3D model was ~ 6 h and 45 min for preoperative shaping of the titanium implant. The intraoperative molding (IOM) of a titanium mesh needed an average of 60 min additional operative room time which incurred $4000. The average cost for PEEK and flat titanium mesh is $12,600 and $6750. Our method resulted in $4000 and $5500 cost reduction in comparison to flat mesh with IOM and PEEK implant.
CONCLUSION CONCLUSIONS
3D printing technology can create a custom model to shape a titanium mesh preoperatively for cranioplasty. It can result in excellent cosmetic results and significant cost reduction in comparison to other cranioplasty options.

Identifiants

pubmed: 33033650
doi: 10.25259/SNI_482_2020
pii: SNI-11-288
pmc: PMC7538793
doi:

Types de publication

Case Reports

Langues

eng

Pagination

288

Informations de copyright

Copyright: © 2020 Surgical Neurology International.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

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Auteurs

Michael Kinsman (M)

Department of Neurosurgery, Kansas University, Kansas City, Missouri.

Zaid Aljuboori (Z)

Department of Neurosurgery, University of Louisville, Louisville, Kentucky, United States.

Tyler Ball (T)

Department of Neurosurgery, University of Louisville, Louisville, Kentucky, United States.

Haring Nauta (H)

Department of Neurosurgery, University of Louisville, Louisville, Kentucky, United States.

Maxwell Boakye (M)

Department of Neurosurgery, University of Louisville, Louisville, Kentucky, United States.

Classifications MeSH