Kabra Apoorva, Mehta Nishank, Garg Bhavuk
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
J Clin Orthop Trauma. 2022 Oct 20;35:102044. doi: 10.1016/j.jcot.2022.102044. eCollection 2022 Dec.
3D printing (3DP) has been brought to medical use since the early part of this century- but it has been widely researched on and publicized only in the last few years. Amongst patients with spinal disorders, 3DP has been utilized in various facets of patient care. These include pre-operative aspects - such as patient education, resident training, pre-operative planning and simulations, intra-operative assistance in the form of customized jigs for pedicle screw insertion, patient specific interbody cages and vertebral body substitutes in complex malignancies and spinal infections. It has also been utilized in deformity surgeries and has opened new avenues in minimally invasive spine care. Guidelines have now been drafted by various organizations including the FDA with a prime focus on quality control measures applicable to this new technology. There has been a recent surge in publications supporting the use of 3DP in spinal disorders, reporting an improvement in various aspects of patient care. As the technology spreads out its wings further, more innovations and applications are expected to unfold in the coming years. Considering the rapid advances that 3DP has made, having a basic understanding of this technology is imperative for all spine surgeons. Despite promising preliminary results, there still exist a few pitfalls of the technology which have hindered the universal application of 3DP. Most importantly, there is a dearth of data related to long term outcomes supporting its clinical use. The prohibitive cost of 3D models, the specialized manpower it necessitates and the need for specific instrumentation are major deterrents to widespread use of this technology, particularly in small-scale healthcare setups. With further advancements in technology, the goal must be to make it more accurate and affordable to hospitals and patients so that the benefits of the technology can reach a wider patient population.
自本世纪初以来，3D打印（3DP）已被应用于医学领域，但直到最近几年才得到广泛研究和宣传。在脊柱疾病患者中，3DP已被应用于患者护理的各个方面。这些方面包括术前阶段，如患者教育、住院医师培训、术前规划和模拟、术中通过定制椎弓根螺钉置入夹具、患者特异性椎间融合器以及用于复杂恶性肿瘤和脊柱感染的椎体替代物提供辅助。它还被用于畸形手术，并为微创脊柱护理开辟了新途径。包括美国食品药品监督管理局（FDA）在内的各种组织现已起草了指南，主要侧重于适用于这项新技术的质量控制措施。最近有大量支持在脊柱疾病中使用3DP的出版物，报道了患者护理各个方面的改善。随着这项技术进一步展翅发展，预计未来几年会有更多的创新和应用出现。鉴于3DP取得的快速进展，所有脊柱外科医生都必须对这项技术有基本的了解。尽管取得了令人鼓舞的初步结果，但这项技术仍然存在一些缺陷，阻碍了3DP的普遍应用。最重要的是，缺乏支持其临床应用的长期结果相关数据。3D模型成本高昂、需要专业人力以及需要特定仪器是阻碍这项技术广泛应用的主要因素，尤其是在小规模医疗保健机构中。随着技术的进一步发展，目标必须是使其对医院和患者更准确且更经济实惠，以便该技术的益处能够惠及更广泛的患者群体。
