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3D-printed spine surgery implants: a systematic review of the efficacy and clinical safety profile of patient-specific and off-the-shelf devices

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A Correction to this article was published on 26 May 2020

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Abstract

Purpose

Three-dimensional printing (3DP), or additive manufacturing, is an emergent fabrication technology for surgical devices. As a production method, 3DP enables physical realisation of surgical implants from geometrically complex digital-models in computer-aided design. Spine surgery has been an innovative adopter of 3DP technology for both patient-specific (PS) and market-available ‘Off-The-Shelf’ (OTS) implants. The present study assessed clinical evidence for efficacy and safety of both PS and OTS 3DP spinal implants through review of the published literature. The aim was to evaluate the clinical utility of 3DP devices for spinal surgery.

Methods

A systematic literature review of peer-reviewed papers featured on online medical databases evidencing the application of 3DP (PS and OTS) surgical spine implants was conducted in accordance with PRISMA guidelines.

Results

Twenty-two peer-reviewed articles and one book-chapter were eligible for systematic review. The published literature was limited to case reports and case series, with a predominant focus on PS designs fabricated from titanium alloys for surgical reconstruction in cases where neoplasia, infection, trauma or degenerative processes of the spine have precipitated significant anatomical complexity.

Conclusion

PS and 3DP OTS surgical implants have demonstrated considerable utility for the surgical management of complex spine pathology. The reviewed literature indicated that 3DP spinal implants have also been used safely, with positive surgeon- and patient-reported outcomes. However, these conclusions are tentative as the follow-up periods are still relatively short and the number of high-powered studies was limited. Single case and small case series reporting would benefit greatly from more standardised reporting of clinical, radiographic and biomechanical outcomes.

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Change history

  • 26 May 2020

    Unfortunately, 3rd author’s first name was incorrectly published in the original publication. The complete correct name is given below,

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Authors and Affiliations

  1. Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia

    Joshua L. Burnard, William C. H. Parr, Wen Jie Choy, William R. Walsh & Ralph J. Mobbs

  2. Surgical and Orthopaedic Research Laboratory (SORL), Prince of Wales UNSW Clinical School, Sydney, Australia

    Joshua L. Burnard, William C. H. Parr, Wen Jie Choy & Ralph J. Mobbs

  3. NeuroSpine Surgery Research Group (NSURG), Prince of Wales Private Hospital, Sydney, Australia

    Joshua L. Burnard, William C. H. Parr, Wen Jie Choy, William R. Walsh & Ralph J. Mobbs

  4. 3DMorphic, Sydney, Australia

    William R. Walsh & Ralph J. Mobbs

  5. Department of Neurosurgery, Prince of Wales Private, Sydney, Australia

    Ralph J. Mobbs

Authors
  1. Joshua L. Burnard
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  2. William C. H. Parr
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  3. Wen Jie Choy
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  4. William R. Walsh
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  5. Ralph J. Mobbs
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Contributions

(I) Study conception and design were contributed by JL Burnard, WCH Parr, RJ Mobbs; (II) Administrative Support was contributed by RJ Mobbs, WCH Parr, WJ Choy; (III) Provision of Study Materials was contributed by WCH Parr, RJ Mobbs; (IV) Data Analysis/Interpretation were contributed by JL Burnard, WCH Parr, RJ Mobbs; (V) Manuscript Writing was contributed by JL Burnard, WCH Parr; (VI) Critical Revision of Manuscript was contributed by WCH Parr, RJ Mobbs, WR Walsh.

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Correspondence to Joshua L. Burnard.

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Burnard, J.L., Parr, W.C.H., Choy, W.J. et al. 3D-printed spine surgery implants: a systematic review of the efficacy and clinical safety profile of patient-specific and off-the-shelf devices. Eur Spine J 29, 1248–1260 (2020). https://doi.org/10.1007/s00586-019-06236-2

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