3D-Printed Bones are Helping Doctors Prepare for Surgeries

By Nicoletta Lanese

a hand holds a 3-D printed model of a spine
A 3D-printed spine was created from a clinical CT scan of a patient with a spinal deformity. Being able to see, hold and rotate a precise replica of their patient’s bones gives surgeons a new angle on their cases.  Photo by Barbara Ries

Orthopaedic surgeons can now get their hands on the bones of patients before they reach the operating table ­– with the help of 3D printing.

Using scans of actual patient anatomy, the surgeons are able to print model bones on which to plan and practice their procedures. Being able to see, hold and rotate a precise replica of their patient’s bones gives surgeons a new angle on their cases, providing information that might be invisible on a flat scan.

Shane Burch talks with Musa Zaid
Shane Burch (right), MD, a spinal surgeon in the Department of Orthopaedic Surgery, and Musa Zaid, MD, a research resident in Orthopaedic Surgery, discuss a use of a 3-D printed spine created from a clinical CT scan of a patient with a spinal deformity. Photo by Barbara Ries

These models can be shared with patients to give them a deeper understanding of their upcoming surgeries. In the operating room, they serve as a visual aid for the surgeons and their teams.

The technology is being used widely across UC San Francisco and affiliated health care organizations.

“The total number of orthopaedic surgeons using 3D printing at UCSF is higher than anywhere else in the country,” said Alan Dang, MD, assistant professor of orthopaedic surgery.

It’s not just orthopaedic surgeons taking advantage of this technology – pediatric cardiologists, radiologists, maxillofacial surgeons, dentists and prosthetists are among the many incorporating 3D prints in their work.

Beyond the operating room, the technology is enriching education  and being studied for how it may improve patient care.

3D Printing as a Health Care Tool

Printing onsite, at the hospital, renders the 3D printing a helpful tool, rather than an expensive commodity. A single print can be turned around in less than 24 hours and made with sustainable materials, all for less than the cost of a pair of sterile gloves.

Three-dimensional prints help doctors save precious time in the operating room. For example, with a patient’s printed anatomy in their hands, surgeons can test the fit of surgical implants in advance. Besides saving time on the table, this practice can save money by helping doctors visualize whether a patient needs a pricey custom implant, or just a standard size.

Surgeons and their trainees can also use 3D printing to practice procedures.

“The trainees can actually perform the case on a replica of the patient’s anatomy before the first incision is made,” said Aenor Sawyer, MD, assistant professor of orthopaedic surgery.

a computer screen shows a scan of a skull that will be turned into a 3-D printed model
a 3-D printed model of a human skull
Software prepares a scan of a skull to be sent to a 3D printer at the Makers Lab in the UCSF Library. A finished version of the 3D printed skull sits inside of a lightbox. Photos by Susan Merrell

As both seasoned surgeons and future doctors make use of the technology, Sawyer and her colleagues are researching if and how its application is improving patient care. They want to know which procedures are rendered safer, cheaper and faster by the use of 3D printing.     

“We anticipate,” said Sawyer, “that patient-specific 3D printed models will become a standard tool in precision medicine.”

The growth of 3D printing’s use across UCSF and affiliated health care organizations was spurred in part by an initiative known as EDGE Labs in the UCSF Department of Orthopaedic Surgery. Founded by Alexis Dang, MD, Alan Dang, MD, and Aenor Sawyer, MD, EDGE Labs has established onsite 3D printing at the UCSF Medical Centers at Parnassus and Mission Bay, Zuckerberg San Francisco General Hospital and the San Francisco VA Medical Center.

Along with his EDGE Lab co-founders, Dang aims to make 3D printing equally accessible to UCSF surgeons and proceduralists of all specialties.  

Educating Future Health Care Professionals

The next generation of health care professionals are also stepping into the 3D printing technology mix through access to devices in the UCSF Library and in the classroom.

Anyone with a UCSF ID has access to the Makers Lab – a creative space housed on the main floor of the UCSF Library at Parnassus that has 10 3D printers open for business. UCSF students, faculty, staff, researchers, and practitioners can use the printers, print-planning software and necessary materials at no cost and can print just about anything they can imagine.

Jenny Tai works with Monica Lomanto on a computer
Jenny Tai (left), a lab technician, assists first-year School of Pharmacy student Monica Lomanto with her 3-D printing project. At UCSF, students are learning how to turn scans of body parts into 3D prints. Photo by Susan Merrell

This fall, some of the Lab’s printers will venture beyond the library and into the classroom.

Through a partnership with the Department of Anatomy, the Makers Lab will launch a new 3D printing elective this fall, called “3-D Printing for Health Science Students.” Through the course, the students will learn to transform a common CT scan into a 3D model, from start to finish. They can then take that knowledge forward to tackle their own, more complex projects.

The new 10-week elective – produced by Anatomy Learning Center Director Derek Harmon, PhD, Makers Lab Manager Dylan Romero, and medical student Cecilia Im – boosts the momentum of 3D printing across campus.

“We’re aiming to get 3D printing adopted across all health care systems,” said Sawyer. “Not just here at UCSF.”

Paving the Way for 3D Technology

To cultivate the use of 3D technologies in health care, the UCSF School of Medicine awarded a grant to establish the Center for Advanced 3D+ Technologies. The center – formed by EDGE Labs, the Division of Pediatric Cardiology, and the Department of Radiology – fosters the development of onsite 3D printing, as well as visualization technologies such as virtual and augmented reality.

a 3-D printed model of a human skeletal foot
A 3D model of a skeletal foot sits on the instruction table during an Anatomy 3-D Printing class. The model is one of many UCSF uses to teach Physical Therapy students how to generate 3D printed models from CT scans. Photo by Susan Merrell

Besides developing 3D technologies for patient care, the center supports their use for designing and prototyping new medical devices. Onsite 3D printing allows prototyping to be done easily, in-house, rather than outsourced.

Three-dimensional prints can serve as molds for bone grafts, custom splints or patient-specific implants. Alan Dang is currently designing and printing spinal implant prototypes from PEEK, a common implantable material. Sigurd Berven, MD; Safa Herfat, PhD; and Aenor Sawyer are also prototyping spinal implants onsite at Zuckerberg San Francisco General Hospital.

“In the next couple of years, I think we will see an explosion in UCSF-designed medical devices,” said Alexis Dang, “thanks to the benefits of 3D printing.”