Assess the application, utility, and adoption of patient-specific 3DP and VR modeling in three complex surgical spine cases. 

Surgical decision making and outcome measurement remains inconsistent in complex spine disease requiring surgical intervention.^1,2 The emergence of 3DP and VR has created exciting opportunities in patient care. Spinal surgery is an ideal application for this technology with preliminary studies proposing 3DP and VR as powerful tools for complex disease presentations.^3-6

Three patients underwent complex spine surgery between August 2018 to November 2018. The attending neurosurgeon evaluated the impact of 3DP and VR model via questionnaires designed by Ochsner’s Medical 3d lab. Imaging was obtained and de-identified in a standard process in conjunction with the Ochsner Radiology Department. Materialise® Innovation Suite processed DICOM data and created a 3D stereolithography (STL) object. The STL object was then rendered on a Ultimaker S5 Fusion Deposition Molding (FDM) printer utilizing PLA and PBA material. Physicians viewed 3D files in virtual reality (VR) using Co-Lab and head-mounted displays (HMDs). 

All cases were rated as extremely complex due to surgical procedure, risk, and patient co-morbidities. Post-surgical questionnaire results indicated models helped increase understanding of complex patient anatomy. One model revealed anatomical variations not seen on standard of care imaging. Furthermore, models improved operative planning and lowered surgical complications. 3DP and VR models helped save from 30 mins to greater than 180 mins in the operating room.  

Our results support the hypothesis that patient-specific 3DP and VR models are a novel method to diagnose and treat complex surgical spine outcomes. With the aid of our models, the three patients underwent successful spine surgery with approaches designed and augmented by advanced modeling not feasible with conventional two-dimensional imaging. Further research should investigate the efficacy of 3DP and VR models in a randomized and controlled manner.