When Charlotte Massey was born, she had a whole list of problems, including a partially formed spine with a missing thoracic vertebrae. She had only three of the twelve ribs that support the left lung, which, as a result, never developed to its full size. Her heart was incorrectly positioned on the right side of her chest, and she had one central kidney and an intestinal obstruction. Finally, she had a large skin-covered meningocele, where the membranes that cover the spine and part of the spinal cord protrude through a defect in the vertebral column.
That was obviously a lot for Charlotte’s parents to cope with, but they had time to prepare before she was born, thanks to 3D printing. Ultrasounds and a fetal MRI gave Scott and Elizabeth Massey some idea of what they could expect, but it wasn’t until the Vanderbilt Department of Radiology and Radiological Sciences’ 3-D Printing Center 3D printed a model of Charlotte’s anatomy, focusing on her spine, ribs and lungs, that they began to understand.
“When we had a care conference with the model we were able to get a better understanding and an actual visual of what the ribs look like, especially on the right side where she has them and where they are absent on the left side,” said Scott. “We could hold it and see that this is what our daughter’s anatomy looks like.”
“To hear her ribs are fused together: well what does that mean?” added Elizabeth. “[The model] helps to give a clearer picture of her story. We were able to ask questions we might not have considered.”
The 3-D Printing Center was recently opened, located on the first floor of the Monroe Carell Jr. Children’s Hospital at Vanderbilt. It has three 3D printers that can create models anywhere from the width of a human hair to the length of a human leg. A 3D scanner and Materialise Mimics Innovation Suite are also used. Since January, the center has produced more than 56 models for different purposes.
“One of the goals at Vanderbilt is innovation, and this technology certainly is in keeping with that mission. 3-D printing is innovative and part of the future of medicine,” said Center Director Sumit Pruthi, MD, Associate Professor of Radiology and Pediatrics and Chief of Pediatric Neuroradiology. “The models can be used for patient education, medical student and resident education/training, surgical planning and simulation. If a person has a tumor with complex surgical anatomy, we can make a 3-D tumor model which the surgeon can hold in his/her hand, in order to optimize surgical planning. Models can also be used to practice complex steps in operations before they are performed.”
3D printed ultrasounds have been used to provide visually impaired parents with an image of their unborn baby, as well as created for parents who just want a three-dimensional keepsake. In Charlotte’s case, however, 3D printing her anatomy before her birth may have been lifesaving. Not only did the model help her parents understand what was happening, it helped her doctors prepare for how they would treat her once she was born. Four days after Charlotte was born via cesarean section, Jay Wellons, MD, chief of Pediatric Neurosurgery, was able to successfully repair her meningocele. Shortly after that, the baby’s pediatric surgeon, Harold Lovvon III, MD, performed two abdominal procedures after examining the 3D printed model.
“It really is helpful to hold the model in one’s hand to look at what the anatomy and malformations are before actually operating on a patient,” said Dr. Lovvorn, Associate Professor of Pediatrics and Pediatric Surgery. “In Charlotte’s case, it was also an excellent teaching tool for the family — and really for everybody on her care team. The model solidified our thinking.”
Charlotte’s care team did look into the option of giving her prosthetic ribs, but found it unlikely as they didn’t have a portion of a vertebral column to attach them to. The model did allow them to discuss care options for treating Charlotte’s severe scoliosis as she grows, however.
“The more information we have as care providers and the more precise that information is, not only can we perform better operations and provide better care, but we can also counsel a family better and they can have a better appreciation of what their baby or child is up against,” said Dr. Lovvorn.
Models at the 3-D Printing Center can be created from one of four different medical and dental materials with a range of colors and textures, which Dr. Pruthi hopes to expand. Anyone at Vanderbilt can request 3D printed models via a link on eStar.
Charlotte is now four months old and will go home when she gets a little bit bigger. She has many difficulties ahead of her, but because of the 3D printed model her doctors examined before she was born, some of her problems were able to be quickly relieved. And that 3D printed model will continue to help her throughout her life; her parents have a copy that they will show to the caregivers who take care of her as she gets older.
Discuss this and other 3D printing topics at 3DPrintBoard.com or share your thoughts below.[Source: Vanderbilt University / Images: Anne Rayner]