Mar 31, 2016

A man in China suffering from severe ankylosing spondylitis, a form of spinal arthritis that causes the vertebrae to fuse together resulting in stiffness and kyphosis, the extreme curvature of the spine, has undergone a successful surgery thanks to a custom 3D printed osteotomy guide. The surgery is the first of its kind in China, and thanks to 3D printing, doctors were able to reduce operating time by half, save over one thousand dollars, and safely perform an otherwise complex and dangerous medical procedure.

Mr Deng, from Shaodong County in Hunan province, had been suffering from ankylosing spondylitis for nearly a decade. The condition, which is most common in young men, had caused his spine to bend 110 degrees, reducing the man who once stood at 170cm tall to just 130cm. Not only could he not sleep properly, Mr Deng had not been able to look up towards the sky in years.

According to doctors at the Third Xiangya Hospital of Central South University, Mr Deng’s condition was so severe that it was affecting his internal organs as well, threatening to crush his heart, lungs, and digestion system.

Although there is no cure for ankylosing spondylitis, in these severe cases a spinal osteotomy can help to reduce symptoms and pain. In this surgical operation, the bone (in this case the vertebrae) is cut to shorten and/or alter its alignment.

After careful examination, Chief physician Zhan Ruisen and his team decided to amputate two bones in Mr Deng’s spine: section 12 thoracic vertebrae at a 35 degree angle, and section 3 lumbar vertebrae at a 40 degree angle. Even with this careful planning, the team knew the surgery would be risky. “The spine is the human central nervous system,” explained Zhan. “The slightest mistake will cause excessive bleeding and even paralysis.”

Mr Deng prior to the operation

The medical team thus turned to 3D printing technology in order to create a physical, patient-specific osteotomy guide that would not only show them exactly where to the cut the spine, but actually hold the knife in place ensuring that even the doctor’s carefully trained hands would not slip.

The 3D printed guide, made from a durable nylon material, followed the exact curvature of Mr Deng’s spine. It also featured two precisely angled slits where the surgical knife could enter. During the surgery, doctors carefully inserted the knife exactly where indicated, and were able to precisely remove the vertebrae without any complications.

According to Zhan, this kind of surgery typically requires 10 hours in the operating theatre, 6000ml of blood transfusion, and one week of recovery in intensive care. Prior to Mr Deng’s treatment, the hospital had prepared multiple orthopedic hospital departments, 6000ml of blood, anesthetic and more to ensure Dr Deng’s safety. However, he said, “due to the successful use of the 3D printed osteotomy guide plate, we didn’t use the emergency plans, the surgery went very smoothly.”

In the end, Mr Deng’s surgery took only 5 hours, required 1000ml of blood, and he could go straight to the general ward, saving the hospital more than RMB 10,000 (US $1,550).

Although this is the first time in China that a personalized 3D printed surgical guide has been used in an osteotomy surgery, Mr Deng’s story could be used as a successful case study, encouraging more doctors and hospitals to adopt 3D printing technology for similar operations, thereby simplifying complex surgeries and helping to save lives.

Best of all, Mr Deng’s kyphosis has been dramatically reduced, allowing him to walk nearly upright and look towards the sky for the first time in nearly ten years.




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