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Houston Neurosurgeon: 3D Printing Saves Time in OR

HOUSTON – 3-D printing has been assisting surgeons through the most complicated operations imaginable for about four years.

At the Houston Methodist Research Institute, the director of MRI Core works specifically with neurosurgeons to help them map brain surgeries before stepping foot into the operating room.

It starts with an MRI of the brain. A special software converts that scan into a 3-D image. Then, a 3-D printer heats plastic, printing 0.2 millimeters layer by layer on top of each other to create a plastic replica of a patient’s brain.

“Takes about 11 hours. Eleven, 12 hours, but once we have that, we have a three-dimensional model,” said Christof Karmonik, director of MRI Core at Houston Methodist Hospital.

“What we did in the past makes us look like dinosaurs compared to what we can do now with all this advanced technology,” Dr. David Baskin, professor of Neurosurgery at Houston Methodist Hospital, said.

Baskin said now a patient is cosmetically perfect after the reconstruction.

“If you have a bad stroke, have a lot of brain swelling, we actually remove a piece of the skull so there’s room for the brain to swell out. It actually saves lives. The only problem is, after it’s all over, you’ve got a big defect, a big hole in your skull. The skull is no longer available, it’s been discarded or let’s suppose you had a gunshot wound to the head with a patient where their skull was shattered, now you’re walking around with a caved-in skull, and the challenges to produce a new skull that will fit perfectly in place,” Baskin said. “No matter how good you are, it’s very hard for you to contour the exact shape of the skull. But now with computers and 3D printing, we make a CAT scan and the computer reconstructs the way your skull should look and makes a new skull … and this thing fits like a glove.”

Besides cosmetics, it’s critical for the skull to be as perfectly positioned as possible. The skull protects your brain from every trauma it could encounter, from major hits to minor bumps.

“We all bump our heads and bunk our heads three or four times a day and if you didn’t have a skull and you hit that area of your scalp, you could injure your brain. So you want to put this back to protect the brain, protect the inside of the head, and you want to put it back in a way where there’s no gaps, where there’s no bumps, where there’s no lumps because if you hit those bumps or lumps they could in turn produce trauma so you really need something that’s going to fit perfectly into place like the original product. Along comes 3-D printing and we’re now able to do that,” Baskin said.

Prior to 3-D printing, bone cement (typically used for hip replacements) was used to fill in the skull after these kinds of operations. Baskin said it was agonizing trying to make bone cement fit perfectly into the patient’s open skull, not to mention it added hours in the operating room.

“Definitely longer and definitely more complicated. Where now, you expose the defect, you pop this in, we sew the scalp back together and it’s cut down the operation by more than half,” Baskin said.



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