Kinsman Michael, Aljuboori Zaid, Ball Tyler, Nauta Haring, Boakye Maxwell
Department of Neurosurgery, Kansas University, Kansas City, Missouri.
Department of Neurosurgery, University of Louisville, Louisville, Kentucky, United States.
Surg Neurol Int. 2020 Sep 12;11:288. doi: 10.25259/SNI_482_2020. eCollection 2020.
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.
颅骨修补术是一种修复颅骨缺损的神经外科手术。有时，由于各种原因患者的骨瓣无法使用。替代方案包括定制的聚醚醚酮（PEEK）植入物或钛网；两者都会产生额外费用。我们介绍一种使用3D打印机创建患者特异性3D模型的技术，该模型用于术前塑造钛网。
我们纳入了三名无法使用骨瓣的患者。我们收集了患者的人口统计学、植入物及3D打印机的费用和时间数据。患者的计算机断层扫描DICOM图像用于颅骨缺损的3D重建。使用一台3D打印机（Flashforge，加利福尼亚州）打印缺损的定制模具，该模具用于塑造钛网。所有患者均获得了极佳的美容效果且无并发症。打印一个3D模型所需时间约为6小时45分钟，用于钛植入物的术前塑形。钛网的术中塑形（IOM）平均需要额外60分钟的手术室时间，产生4000美元费用。PEEK和平坦钛网的平均成本分别为12,600美元和6750美元。与采用IOM的平坦钛网和PEEK植入物相比，我们的方法分别降低了4000美元和5500美元的成本。
3D打印技术可以创建定制模型，用于颅骨修补术前塑造钛网。与其他颅骨修补方案相比，它可以产生极佳的美容效果并显著降低成本。
