3D-Printed Anatomic Modeling for Surgical Planning and Real-Time Operative Guidance in Complex Primary Spinal Column Tumors: Single-Center Experience and Case Series.

Abstract (223 / 250 words max) Object Three-dimensional (3D) printing has emerged as an available visualization tool for clinicians and patients. We sought to utilize patient-specific 3D-printed anatomical modeling for preoperative planning and live intraoperative guidance in a series of complex primary spine tumors. Methods Over nine months, patients referred to a single neurosurgical provider for complex primary spinal column tumors were included. Most recent spinal MR and CT imaging were semi-automatically segmented for relevant anatomy and models were printed using polyjet multi-color printing technology. Models were available to surgical teams before and during the operative procedure. Patients also viewed the models preoperatively during surgeon explanation of disease and surgical plan to aid in their understanding. Results Tumor models were prepared for nine patients, including four chordomas, two schwannomas, one osteosarcoma, one chondrosarcoma, and one Ewing-like sarcoma. Mean age was 50.7 years (range 15–82), including six males and three females. Mean tumor volume was 129.6 cm3 (range 3.3–250.0 cm3). Lesions were located at cervical, thoracic, and sacral levels and were treated by various surgical approaches. Models were intraoperatively utilized as patient-specific anatomic references throughout seven cases and were found to be technically useful by the surgical teams. Conclusions We present the largest case series of 3D-printed spine tumor models published to date. 3D-printed models are broadly useful for operative planning and intraoperative guidance in spinal oncology surgery.