Application and development prospect of 3D printing technology in neurosurgery（A）

Authors: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University;

Department of Neurosurgery, Peking University International Hospital;

Department of Neurosurgery, Tianjin Fifth Central Hospital (Wang Liang)

The emergence of 3D printing technology has brought great changes to the manufacturing industry. The technology develops rapidly and is widely used in medical treatment, biological tissue engineering, industry, military, aerospace and other fields.President Barack Obama acknowledged the importance of 3D printing in a 2013 State of the Union address.On August 21, 2015, member of bing-heng lu in the collective learning of the State Council meeting for 3 d printing special reports, has drawn great attention of countries, and put forward: “3 d printing is a manufacturing representative of disruptive technology, implement made from materials such as, reduced to gain significant shift, change traditional manufacturing concept and mode, has a significant value”.

In recent years, 3D printing technology has set off a boom in neurosurgery. It has been applied successively in cerebrovascular diseases, cranial base tumors, spinal cord and other fields to assist preoperative operation planning, doctor-patient communication, clinical teaching, technical training and so on.3D printing materials have been developed rapidly, and some of them have been used in clinical practice, such as 3D printing skull repair materials, 3D printing artificial repair of dura mater, etc., which show great advantages and high application value.This paper reviews the application of 3D printing technology in neurosurgery.

1.3 Introduction of D printing concept

3 d Printing, 3 d Printing technology, also known as rapid prototyping technology (rapid prototyping) or add material (i.e. manufacturing), refers to a kind of in contrast to the traditional material removal machining method, based on three dimensional CAD model data, through increased step by step a material, reverse make exactly the same as that of the corresponding mathematical model of three dimensional physical entity manufacturing method of the model.The idea of this technique originated from an American patent on stratified tectonic landforms in the late 19th century.In 1984 CharlesHull, an American scientist, invented the technique of printing digital resources into three-dimensional models.Two years later, ChuckHull developed the stereoscopic lithography process, which USES ultraviolet light to solidified resin for modeling and patented the first commercial 3D printing machine, marking a milestone in the development of 3D printing technology.

It took 10 years from the first 3D printer developed by American ZCorp in 1995 to the first HIGH-DEFINITION color 3D printer released in 2005.Since 2010, 3D printing has entered the stage of rapid development. From GUN to clothing, from cars to jewelry, 3D printing technology can be used for manufacturing.The application of 3D printing technology in the medical field started from dental and maxillofacial surgery, and has been explored and developed in various medical sub-disciplines.Printing materials for surgical applications are usually based on powders, including nylon powder, ABS powder, metal powder, ceramic powder and stem cell solution, etc. Different materials can be selected according to the nature of the target print, such as ceramics, plastics, resins, superalloys, stainless steel and titanium, etc.The printing accuracy mainly depends on the equipment used. The anatomical structure of 3D printing is highly accurate compared with the original specimen. One study reported that the average error of the 10mm specimen of structure > was (0.32±0.054) mm.The latest 3D printing technology has made it possible to print materials of different textures, that is, multicolor qualities (such as bones, tendons, etc.) to more accurately reproduce the original specimen.

2.3 Application of D printing in neurosurgery

2.1 Application of 3D printing in teaching and training of neurosurgery

In 2017, the General Office of the State Council issued the Opinions on Deepening the Cooperation between Medicine and Education to Further Promote the Reform and Development of Medical Education, which put forward higher requirements on the cultivation of high-quality medical personnel, with the emphasis on comprehensively improving the quality of talent cultivation and strengthening the cultivation of clinical ability of medical students.Neurosurgery is unique, complex, stereoscopic, precise and so on. It needs good spatial imagination ability and continuous reinforcement learning of anatomical structure to achieve good training effect.

In the current medical education system, neurosurgical craniocerebral anatomy is divorced from surgical operation teaching, and a large number of neurosurgeons have serious training and learning needs from medical school graduation until they are proficient in all levels of surgery.The shortage of required anatomical specimens of the brain and the scarcity of disease-specific specimen models have been addressed with the introduction of 3D printing in teaching.WANG et al. used 3D printed aneurysm model to train young neurosurgeons, which can improve their understanding of aneurysm anatomy.At the same time, the basic surgical skills of young surgeons can be improved.Foreign clinicians use 3D-printed ventricle models for the training of third ventriculostomy. These simulators are composed of reusable basic parts and disposable variable pressure simulation ventricle system, in which neurosurgeons can perform surgical simulation operation.