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Models for surgical planning.

The field of neurosurgery has experienced significant advancements as a result of 3D printing. This is not surprising given that most of the surgical procedures and corresponding pathologies that neurosurgeons encounter are exquisitely complex, involving intricate, minute anatomical structures, that cannot always be sufficiently appreciated via two-dimensional multi-planar imaging. Although diagnostic imaging has indeed evolved from 2D renderings, these images are still viewed on a flat 2D computer screen. This makes interpretations related to depth difficult, forcing a surgeon to mentally construct complicated vasculature.

Accurate 3D models of patient-specific anatomy enable visualization of anatomical structures from different angles and also facilitate procedural skills practice. The latter is particularly important in the field of neurosurgery, due to the high-stakes nature of procedures within this specialty, and the otherwise slow, step-wise accumulation of operative skill when working with real patients. In addition to surgical planning and procedure simulation, 3D models have contributed to the development of customizable, patient-specific neurosurgical implants and prosthetic devices.

Recent publications have described a vast array of applications for 3D printing in several subspecialties of neurosurgery. These areas include cerebrovascular, neuro-oncologic, spinal, functional and endoscopic neurosurgery. Clinical applications include the treatment of pathologic cerebral vasculature, brain tumors, spinal cord conditions, treatment-resistant neurological disorders, and remotely located pathology, respectively. Each of these fields has uniquely harnessed 3D printing to advance surgical planning, training, and treatment for improved patient outcomes.

The first section of the present review will provide an overview of the literature that has been published since Randazzo and associates’ 2016 systematic review on the use of 3D printed patient-specific models for presurgical planning and physician education. The second section will then look at how some of the themes identified in the literature are at work in presurgical planning and training simulation at the Jacobs Institute/Gates Vascular Institute (JI/GVI) in Buffalo, New York. The review will conclude with some hypotheses for the future role of 3D printing in neurosurgery that can be made based on the recent literature and 3D printing practices at the JI/GVI.

 
3D printed presurgical medical model.

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