Cranial Design Surgery 3d Printing

3d printed skull 3d printed implant

Gaurav Gupta, MD, assistant professor of neurosurgery at Rutgers Robert Wood Johnson Medical School (left) with patient Chris Cahill who received a 3-D printed skull. [Image from John Emerson/Rutgers]

A New Jersey doctor turned to Johnson & Johnson's DePuy Synthes and a 3D printed implant to replace missing skull bone in a patient. The procedure was performed after the patient suffered brain swelling and the skull became infected.

Dr. Gaurav Gupta, assistant professor of neurosurgery at Rutgers Robert Wood Johnson Medical School, had to perform emergency surgery on Chris Cahill after he was suffering from life threatening brain swelling in the frontal lobe. Gupta relieved the pressure and intended on replacing the skull once the swelling went down, but the skull became infected and was unusable. His solution was to use 3D printing to replace the missing skull bone.

3D printing is the process of creating a 3D object out of a 2D computer file. The appeal of 3D printing is its precision, accuracy and, in the medical world, the ability to quickly make changes to models. Gupta used 3D printing to create a model of Cahill's skull using a CT scan and created a custom implant from the model.

"The model was used for practice," said Gupta, who is also the director of cerebrovascular and endovascular neurosurgery at Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital, in a press release. "Once the skull implant was printed, millimeter by millimeter, we matched the new implant to the skull model, ensuring a perfect fit."

Gupta created two separate implants because the skull was rather large and was able to bond the two pieces together.

In collaboration with Johnson & Johnson's DePuy Synthes, a 3D printed custom cranial skull implant for Cahill was created out of polyetheretherketone (PEEK). PEEK's strength stability and biocompatibility make it an ideal material for a cranial implant.

In the past, surgeons had to use metal mesh to replace skull bones, which tended to be weak and lacked precision. 3D printing eliminates that problem because it uses medical imaging to create a custom implant.

Before the surgery could be performed, Cahill needed to grow skin to be able to cover the implant. Tushar Patel, a plastic and reconstructive surgeon, was recruited by Gupta to help insert a tissue expander so that Cahill could grow enough skin for the surgery.

The incision for the surgery is behind the hair line which means there were no visible scars and the surgery was a success.

"I was nervous about what I would look like after the surgery. I was happy and I looked exactly the same and felt like myself again," said Cahill.

3D printing has also had a remarkable effect on other surgical procedures. Researchers have created 3D models for heart valve replacement surgeries, training surgeons, educating patients and more.