3D printed modeling contributes to reconstruction of complex chest wall instability

Area of Science:

• Medical engineering
• Surgical planning
• 3D modeling

Background:

• Complex chest wall reconstruction presents challenges due to anatomical deviations from prior surgeries or non-union.
• Three-dimensional (3D) printing offers a novel approach for pre-operative planning and surgical execution in these complex cases.
• Patient-specific 3D models aid in visualizing and addressing intricate anatomical abnormalities.

Observation:

• Computed tomography (CT) imaging data was segmented using medical CAD software to create 3D volumetric meshes.
• Stereolithography (STL) files were generated for a material jetting 3D printer, utilizing UV light-cured photopolymers.
• A case study involved a 55-year-old male with a symptomatic mobile chest wall following prior repair, revealing fractured cartilage and rib mal-alignment.

Findings:

• 3D printed models accurately depicted fractured cartilage and rib mal-alignment, guiding surgical intervention.
• A mirrored model of contralateral ribs quantified the precise geometry of the chest wall defect.
• Surgical repair involved wire cerclage removal, sternocostal non-union plating, and stabilization of rib non-unions, leading to improved patient symptoms and alignment.

Implications:

• While 3D printing costs are substantial, they may be offset by reduced operative time and re-operation rates.
• Early adoption of 3D printing technology can enhance surgical quality and individualized patient care.
• Patient-specific models facilitate the identification of subtle anatomical features missed by standard CT rendering, advocating for surgeon-modeler collaboration.