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Spine Feature


First 3-D Printed Spine Cage Implanted

Walter Eisner • Wed, June 11th, 2014

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The world's first spinal fusion surgery using customized spine cages created with a 3-D printer was performed on May 28, 2014 by Vincent Fiere, M.D. at the Hospital Jean Mermoz in Lyon, France.

The operation, according to a news release from French-based MEDICREA group, used the company's UNiD ALIF intersomatic anatomical inter-body device.

Design, Record and Print

The device was developed from a 3-D digital file created from the extraction and treatment of pre-operatory scanner images of the patient, a process developed internally by the company’s R&D teams. "The company’s design, recording and production methods open the door to the future development of implantable devices that can identically reproduce the elements of the spine that need to be reinforced or replaced by artificial components printed in 3-D on implantable polymers or titanium, " said the company statement.

Dr. Fiere said the cage, specifically ‘printed’ by MEDICREA for his patient, "positioned itself automatically in the natural space between the vertebrae and molded ideally with the spine by joining intimately with the end plates, despite their relative asymmetry and irregularity. I could also very precisely perform the restoration of the disc height and simultaneously correct the degree of lumbar lordosis using plans I had made several days before the operation with the help of MEDICREA's Surgimap software tool.”

The device extends the company's UNiD platform, following the launch of the UNiD pre-curved osteosynthesis rod service in Europe earlier this year.

“Continuing our trajectory since the launch of our PASS LP UNiD rods which are made to measure for each patient, MEDICREA confirms its position as the pioneer of intelligent spinal implants, perfectly adapted to the morphology of each patient’s spinal column and developed in a rational and planned manner to restore the fundamental mechanical equilibrium of the human body, ” said company President and CEO Denys Sournac. “By providing pre-planned customization, our goal is to improve patient outcomes and allow our surgeons customers to complete their plans in advance and solely focus on executing their strategy in the OR.”

MEDICREA has 120 employees with headquarters near Lyon, France. The company also has a manufacturing facility for surgical instruments and implants located in La Rochelle as well as three distribution subsidiaries in the U.S., the UK and France.

FDA Oversight

The regulatory pathway for printed devices is still in its infancy. The FDA says 3-D printed devices are treated like any other medical device. The agency has two laboratories that are looking into ways 3-D printing could affect the way medical devices are manufactured in the future.

The FDA's Functional Performance and Device Use Laboratory uses computer-modeling methods to determine how tweaks to a medical product's design could affect its safety and performance in various patient populations. The agency says understanding the effect of these tweaks helps the FDA evaluate devices that are customized to an individual patient or group.

The FDA's Laboratory for Solid Mechanics focuses on how different printing methods affect the strength and durability of the materials used to make the devices. The lab's findings "will help us to develop standards and set parameters for scale, materials, and other critical aspects that contribute to product safety and innovation, " FDA scientists wrote in a recent blog post.

"Scan me up, Scotty."

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9 Responses to “First 3-D Printed Spine Cage Implanted”

  1. Shon Conine says:

    I don’t think that this is accurate. 4 Web, a company based in Texas that has implanted spinal implants using 3-D printed titanium implants for at least a year.

  2. mike says:

    4Web (a very novel technology) is 3D printed but at this time is not patient specific within the spine. The author should have stated this detail in the title. I am not a 4Web employee.

  3. Matthew Corson says:

    Since cost is so important to hospitals , I wonder if this technology will increase unwanted costs for hospitals, patients and insurance companies.
    There will have to be studies on whether the outcomes make sense to use an implant that is probably very expensive.

    • Walter Eisner says:

      Good question, Matthew.
      We don’t know how costs compare. We are particularly interested in how this is regulated. Manufacturers need FDA clearance for any changes they make to products. Customized devices made by providers may fall under the practice of medicine and out of reach of the FDA. On the other hand, we’ve seen our friends in biologics struggle with the FDA over defining the practice of medicine and federal oversight of manipulated cells and additives. Guttenberg’s printing press caused a disruption. We may be seeing another disruption.

  4. Timothy Ganey says:

    I would echo the sentiments expressed earlier that 4WEB has patients with printed cages that are FDA approved in hte US, and have been implanted more than 2 years. They also have developed and deployed printed 3D patient-specific implants for anatomical replacement following tumor removal.

  5. We have started 2009 with SLM selctive laser melting
    titanium interbody fusion devices.
    we have 4000 cages on file.
    we have lounged newest generation with poresize 400-800ym 2013
    we have fusion after 6 month cervical and 9 month lumbar.
    30% titanium and 70% air ratio makes the implant as good as PEEK in MRI. No artefacts.
    I do not understand all statements- “we are the first”?
    Kindest regards C.Roebling CEO Maxxspine

  6. Steve Clement says:

    4Web has also produced custom 3D printed titanium plants for foot and ankle surgery.

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