Is 3D printing the future of spinal implant technology? 4 key thoughts

Surface Technology

Three-dimensional printing is one big trend in orthopedic and spine devices today.

Here, four spine surgeons discuss their thoughts on 3D printed implants and how the technology could be beneficial in the future.

Mark M. Mikhael, MD. Spine Surgeon at NorthShore University HealthSystem's Orthopaedic Institute and Illinois Bone & Joint Institute (Chicago & Glenview, Ill.): I am most excited to see how 3D printing will grow with regard to the different materials used, specifically porous metal and biologically favorable implants so they can grow onto bone, similar to what we see in total joint replacement. When it comes to custom implants for spine surgery, they are mainly used as spacers or cages to hold for fusions. The technology is promising but not necessary for all spinal pathologies; most typical patients fall into pre-set implant sizes and don't need custom printed implants.

As a potential advantage going forward, premade 3D-printed devices can be most useful to determine an appropriate implant size, so the surgical team can prepare the correct implant for surgery, instead of bringing multiple styles and trials into the OR. In this way, 3D-printed implants do provide a cost-savings in our value-based healthcare system and might continue to do so as this technology evolves. Finally, 3D-printed spine models can be useful in deformity surgery when based off preoperative CT scans. This can allow surgeons to better prepare for osteotomies and implant placement prior to the procedures.

Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: The 3D printing realm is really exciting. I think custom-printed implants will most definitely grow. As the costs come down, you will see its use spread. And I think as surgeons can convince purse-holders that these implants cut down on failure and on operating room time, it will take off.

Todd Lansford, MD. South Carolina Sports Medicine & Orthopaedic Center (Charleston): Using 3D printing, device manufacturers can now create spacers with improved biocompatible performance. This includes improvements in decreasing subsidence due to better modulus of elasticity matching. It also includes materials that encourage bone growth and even boney incorporation. We are now seeing the ability to combine 3D printing with expandable technology. The use of expandable grafts is even more promising with evidence showing decreased rates of subsidence.

Payam Farjoodi, MD. Orthopedic Spine Surgeon at Spine Health Center at MemorialCare Orange Coast Medical Center (Fountain Valley, Calif.): This exciting technology allows patients to have a surgery that is tailor fit for their specific [needs]. By using preoperative imaging, the surgeon has the ability to pick the ideal implant for that particular spine rather than [being] forced to use a "one size fits all" approach. The biggest negative, as of now, is the availability of these devices and the ease with which to plan and obtain them. As 3D printing evolves, a local or on-site printer may reduce these difficulties.

This article includes response gathered by Becker's Healthcare Senior Writer Anuja Vaidya.

 

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