3D printing in pediatric neurosurgery: experimental study of a novel approach using biodegradable materials

Childs Nerv Syst. 2024 Mar 1. doi: 10.1007/s00381-024-06342-7. Online ahead of print.

Abstract

Purpose: 3D printing technologies have become an integral part of modern life, and the most routinely used materials in reconstructive surgery in children are biodegradable materials. The combination of these two technologies opens up new possibilities for the application of innovative methods in neurosurgery and a patient-centered approach in medical care. The aim of the study was to determine whether a physician without specialized programming and printing skills could independently create materials in a clinical setting for the treatment of patients.

Methods: We conducted a preclinical study on 15 male Balb-C mice. Cylindrical materials made of polylactic acid (PLA) plastic were 3D printed. Sterilization of the obtained material was performed using a cold plasma sterilizer with hydrogen peroxide vapor and its plasma. The sterile material was implanted subcutaneously into the mice for 30 days, followed by histological examination. Using open-source software for modeling and printing, plates and screws made of PLA plastic were manufactured. The produced components were tested in the biomedical laboratory of the institute.

Results: The histological material showed that no inflammatory changes were observed at the implantation site during the entire observation period. The cellular composition is mainly represented by macrophages and fibroblasts. There was a gradual resolution of the material and its replacement by native tissues. Research conducted to assess the effectiveness of material sterilization in a cold plasma sterilizer demonstrated its high bactericidal efficiency.

Conclusion: The method we developed for obtaining biodegradable plates and fixation elements on a 3D printer is easy to use and has demonstrated safety in a preclinical study on an animal model.

Keywords: 3D printer; Additive technologies; Children; Fixation devices; Neurosurgery; Polylactide materials.