Feb. 3, 2011 – The Center for Injury Biomechanics group won the 2010 Cook Innovation Award for our submission describing our use of rapid prototyping for surgical planning. We were presented with the award during the annual Greater Winston-Salem Chamber of Commerce meeting on October 19th, 2010. The team that wrote the submission and gave a brief presentation included Dr. Joel Stitzel , Dr. Alex Powers, Kerry Danelson, and Ashley Weaver. The rapid prototyping work described was completed in collaboration with Dr. Lisa David, Dr. John Frino, Dr. L. Andrew Koman, E. Stanley Gordon, Philip Brown, and Josh Tan.
Three-dimensional, rapid prototyped models of patient-specific anatomy are valuable to surgical planning. We have produced over 90 models at Wake Forest University Baptist Medical Center that have been used by surgeons for pre-surgical planning and to identify incision location and instrumentation placement during the operation. We present more detail on two specific types of surgeries that utilized the models we produced to reduce surgical time, invasiveness, and complication risk. The patient benefits from use of the models through improved patient recovery and outcome. The models can also reduce anxiety of the patient and family by providing a medium through which surgeons can explain the planned procedure.
Orthopedic and neurosurgeons used our printed model in a spinal correction surgery for a pediatric patient with severe spinal deformity. The model was used for pre-operative planning of incision locations and placement of rods and screws. During the operation, the surgeons used the spine model to accurately determine the degree of spine curvature. This was vitally important because the screws must be inserted at a correct angle to avoid damaging the spinal cord. With the model, the surgery was less invasive because the patient’s exposed spinous processes could be used to orient the model, eliminating the need for the surgeons to clear away additional tissue to view the spine. Following the surgery, the spine model was also used to explain the surgery to the patient’s family. The family and the surgeon were able to communicate in a more fluid manner due to the visual aid, as they used it to point and illustrate the changes made during the procedure and ask questions.
Fig. 1a: Computed tomography rendering of spinal deformity.
Fig. 1b: Segmented spine model printed using rapid prototyping technology.
Craniosynostosis is the premature fusion of the sutures in the pediatric skull. This disorder causes the skull to develop abnormally and has been associated with abnormalities in cerebral profusion, cerebral metabolism, and intracranial pressure. The use of three dimensional models to pre-fabricate springs for spring mediated cranioplasty has reduced the amount of time pediatric surgical patients are in the operating room. In the vulnerable pediatric population, any method of reducing anesthesia time benefits the patient greatly. Another benefit is this modeling technique can be done in a relatively short amount of time; therefore, for planned procedures such as these, a model can be easily produced for each procedure. The surgeons involved in these procedures have noted that the time to complete the procedures is reduced and the procedure is less invasive with pre-bent springs. The surgeons now request a patient specific print for all patients with craniosynotosis.
Fig. 2a: Computed tomography rendering of sagittal fusion.
Fig 2b: Printed 3D pediatric skull model used for pre-operative planning of spring placement.