India: First 3D printed titanium vertebrae implant helps 32-year-old woman walk again

Feb 17, 2017 | By Benedict

Doctors in India have helped a 32-year-old woman back onto her feet by rebuilding part of her spine with 3D printed vertebrae in a first-of-its-kind procedure. The patient had been suffering from spinal tuberculosis.

Dr Gopal Kumar and Dr V Anand Naik created a 3D printed titanium vertebrae implant

It takes a certain degree of backbone to be a doctor, but—incredibly—it took just a 3D printer for these Indian doctors to make a backbone for a 32-year-old spinal tuberculosis patient. Using advanced metal 3D printing technology, a surgical team at Medanta The Medicity hospital in Haryana was able to create 3D printed artificial vertebrae for the woman, the first operation of its kind in India.

Under the guidance of Dr V Anand Naik, a senior consultant for spine surgeries at the hospital, the surgical team was able to replace the damaged vertebrae in the patient’s spine, replacing them with a 3D printed titanium version that bridged the gap between the first and fourth cervical vertebrae. “It was a very complex surgery and the patient’s condition was deteriorating by the day,” said Dr Naik. “It would not have been possible to do it without 3D printing technology.”

The female patient, a teacher by trade, was under the knife for a total of 10 hours, a lengthy spell necessitated by the severe damage suffered by the patient’s first, second, and third cervical vertebrae. The extent of this damage meant that there was no skeletal support available between the skull and lower cervical spine.

The patient received a 3D printed implant to combat spinal tuberculosis (image: The Lancet)

“The challenge for our team was to reach high into the neck without altering the position of the patient,” explained Dr Gopal Kumar, a consultant on the operating team. “The anterior approach and small working field, in cases such as these, are a necessity.”

Although such a procedure comes with many risks for the patient, the unnamed 32-year-old had an extra special reason for wanting everything to go smoothly—especially when the surgeons took the scalpel to her neck area: “As the patient is a singer, preservation of laryngeal nerve was of prime importance,” Dr Kumar said. “Swallowing, chewing, and movement of tongue—all were at risk.”

The medical team was able to create 3D printed titanium vertebrae for the patient by first obtaining CT and MRI scans of the damaged spine. 3D design software was then used to transform these scans into printable models, which were then fabricated using an unspecified metal 3D printer. Further testing was then carried out on the 3D printed implant, and help was sought from design teams from India, Sweden, and the US.

Without the 3D printed vertebrae implant, the patient could have lost her singing voice

Twelve days after the surgery, the patient was walking with minimal support and was entirely free of pain. Furthermore, her singing voice has recovered after being threatened with dysphasia, a language disorder brought about by the patient’s tuberculosis.

“This is the first such surgery in India and probably third in the world by using 3D printing technology,” Dr Naik added. “These techniques have opened a new avenue wherein any type of complex reconstruction can be done in the spine with less collateral damages.”

Posted in 3D Printing Application

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