Step-by-Step Implementation of Three-Dimensional Print Technology in Preoperative Neurosurgery Planning.

This study presents a detailed methodology for integrating three-dimensional (3D) printing technology into preoperative planning in neurosurgery. The increasing capabilities of 3D printing over the last decade have made it a valuable tool in medical fields such as orthopedics and dental practices. Neurosurgery can similarly benefit from these advancements, though the creation of accurate 3D models poses a significant challenge due to the technical expertise required and the cost of specialized software. This paper demonstrates a step-by-step process for developing a 3D physical model for preoperative planning using free, open-source software. A case involving a 62-year-old male with a large infiltrating tumor in the sacrum, originating from renal cell carcinoma, is used to illustrate the method. The process begins with the acquisition of a CT scan, followed by image reconstruction using InVesalius 3, an open-source software. The resulting 3D model is then processed in Autodesk Meshmixer (Autodesk, Inc., San Francisco, CA), where individual anatomical structures are segmented and prepared for printing. The model is printed using the Bambu Lab X1 Carbon 3D printer (Bambu Lab, Austin, TX), allowing for multicolor differentiation of structures such as bones, tumors, and blood vessels. The study highlights the practical aspects of model creation, including artifact removal, surface separation, and optimization for print volume. It discusses the advantages of multicolor printing for visual clarity in surgical planning and compares it with monochromatic and segmented printing approaches. The findings underscore the potential of 3D printing to enhance surgical precision and planning, providing a replicable protocol that leverages accessible technology. This work supports the broader adoption of 3D printing in neurosurgery, emphasizing the importance of collaboration between medical and engineering professionals to maximize the utility of these models in clinical practice.