3D printing is in the news so often today that it is not uncommon now for it to come up in conversation with just about anyone. And while the naysaying has abated quite a bit due to the sheer amount of evidence regarding its usefulness, it would be interesting to be a fly on the wall should someone question 3D printing while speaking to 35-year-old Chris Cahill. Sporting a 3D printed implant in his skull, Cahill is a walking tribute to the wonders of medicine and progressive technology.
The New Jersey native suffered a severe head trauma and was in a coma for two months. As doctors worked to eliminate the life-threatening swelling in Cahill’s brain, his skull developed an infection. That put an end to their hopes for using his own skull bone in a reconstruction surgery. Dr. Gaurav Gupta, assistant professor of neurosurgery at Rutgers Robert Wood Johnson Medical School, examined their options. He determined that the best alternative would be to explore 3D printing. We have previously followed instances of 3D printing for the creation of titanium skull implants, as well as use in surgical models to act as guides in nasal endoscopy surgeries and in the reshaping of a baby’s head.During the process for reconstructing Cahill’s skull, the medical team started by making a 3D printed model, as well as an implant, customized to fit the missing area of Cahill’s skull—as seen on his original CT scan.
“The model was used for practice,” said Dr. Gupta, Director, Cerebrovascular and Endovascular Neurosurgery at Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital. “Once the skull implant was printed, millimeter by millimeter, we matched the new implant to the skull model, ensuring a perfect fit.”
They actually made two implants, due to the volume of the skull area, and then fused them together.
The patient was a little surprised to learn that he would be receiving a 3D printed implant.
“I wondered, can they really do this?” said Cahill. “But Dr. Gupta saved my life once and I trusted him completely.”
Dr. Gupta worked with DePuy Synthes CMF for 3D printing the skull implant; DePuy Synthes has, for its part, been increasing use of 3D technologies in medical applications. They used a material called PEEK, also known as polyetheretherketone. PEEK is well-known for strength and stability, as well as being compatible for a medical situation like this—and certainly better than previous methods with the use of traditionally created metal mesh.Using the CT scans, the team was able to make a patient-specific implant despite the substantial damage to Cahill’s scull. DePuy Synthes sees 3D printing as beneficial in a case like this as the implant fits more snugly due to customization, less time is spent in the operating room, and in the end, the patient looks better too with the incision scar hiding behind the hair line. They are also resistant in the case of an impact.
The surgery to insert the implant took only about four hours, and was very successful.
“I was nervous about what I would look like after the surgery,” said Cahill. “I was happy I looked exactly the same and felt like myself again.”