Introduction Three-dimensional (3D) printing is a rapidly evolving technology that is transforming various fields and its application in surgery, particularly in spinal procedures, has seen substantial growth in the last 10 years. It enables the production of highly accurate, patient-specific custom implants and anatomical models, enhancing preoperative surgical planning and intraoperative decision-making. This article describes the workflow adopted to produce a 3D-printed model of the cervical column of a patient affected by a recurrent giant cervical chondrosarcoma, focusing on its application in the presurgical resection and reconstruction planning. Methods and results We present the case of a 67-year-old female patient with recurrent clear cell chondrosarcoma of the cervical spine. After multidisciplinary discussion, a two-stage (posterior and anterior stage) intentional Enneking inappropriate subtotal resection, followed by adjuvant proton beam therapy (PBT), was planned. One week before the second surgical stage, a surgical simulation was performed on a 3D-printed model. For the 3D virtual modeling, contrast-enhanced CT images of the cervicothoracic spine were obtained for the segmentation of the different anatomical structures. A PolyJet J850 Digital Anatomy® (Stratasys, USA) printer was used due to its ability to assign different materials to each structure, closely mimicking real tissue properties. Surgery was completed without complications, with neurological improvement from American Spinal Injury Association (ASIA) C to D. Adequate decompression and stable reconstruction were achieved. Adjuvant PBT was delivered postoperatively. At the 6-month follow-up, imaging demonstrated good local control and early fusion, and the patient was pain-free and functionally independent. Discussion and conclusion The creation of patient-specific, 1:1 scale 3D-printed anatomical models is a crucial tool in the improvement of preoperative planning, providing crucial tactile and visual insights for complex spinal tumor resection and reconstruction, thereby improving surgical precision and safety.
Robertis et al. (Fri,) studied this question.