AMS 2020: 3D Printing Metals II Keynote by Craig Sungail, Global Advanced Metals

The final keynote presentation at our recent Additive Manufacturing Strategies, held in Boston and co-hosted by SmarTech Analysis, was given by Craig Sungail, the Vice President of Global Research and Development for Global Advanced Metals, which just so happened to be one of the event sponsors. Sungail was part of our new 3D printing metals track, and presented a very interesting talk about tantalum, “the other gray metal.”

“We’ve used other metals for years, like cobalt chrome and stainless steel, to make implants,” Sungail said. “In 80% of the cases, for most people, it’s successful. But 20% of the time, patients aren’t happy with the results.”

He went on to say that there is a 10% revision rate each year for surgical implants 3D printed out of these other materials, for reasons such as infection, fracture, and becoming dislodged. That’s why he said that we should all “consider tantalum as an alternative.”

“This metal has a long history. We’ve been reviewing the literature for the past 25 years. The authors vary – physicians, universities, etc. But there is a broad, diverse group of people investigating this metal for medical devices.”

Sungail explained that these journals have determined that tantalum (Ta) is not toxic, which “can’t be said for some of the other metals out there today.” Additionally, the research shows that when using tantalum for implants, the osseointegration (bone ingrowth) of the implant into existing bone is pretty good, and perhaps even better than implants made with straight titanium or the Ti-64 alloy.

He pulled up a slide listing some of the other benefits of using tantalum to fabricate medical implants, including the fact that it could enhance local host defense mechanisms, and that it may even have some antibacterial properties.

Sungail offered a brief history about tantalum, which is a transition metal/element. He explained how the material got its name, bringing up a slide about Greek mythology, which I had not been expecting and was very interesting. Tantalus, the son of Zeus and a nymph, stole ambrosia and nectar from his father, and the punishment definitely fit the crime in this case – he was forced to stand in a pool of water that was tantalizingly close to a fruit tree.

“The water would fade away, and the fruit was just out of reach,” Sungail went on.

Then, in 1802, Swedish analytical chemist Anders Gustaf Ekeberg became the first person to discover tantalum when he successfully separated it from nyobium. Ekeberg was tantalized for a long time attempting to achieve what many others had not, and once he’d succeeded, he was given the honor of naming both of the new elements.

“I’m confident that every one of you has been touched by tantalum in some way,” Sungail said. “It’s highly conductive, with a high melting point, chemical and corrosion-resistant, dense, hard, ductile, and biocompatible. We have to use biocompatible carefully, but I’m using it with the FDA definition – it’s been implanted in some way into the body, and studies concluded that the implant was biocompatible.”

Sungail said that the most common application for tantalum is in the capacitor sector, such as when it’s used for cell phones. It does have a 40-year history in medical devices, and it can be mixed with materials in order to make super elements, which can be used in turbines for jet engines and energy generation.

He explained that the company is “truly global,” with locations in the US and Japan. GAM also has a controlling interest in the largest reserve of tantalum in the world, which is in Australia. I’m skipping ahead a little, but I thought this was a good question – at the end of the presentation, an attendee asked Sungail about the potential environmental impact of mining tantalum. He explained that GAM does what he referred to as a “bag and tag” when they receive ore from a conflict country.

“We ensure the money isn’t going to terrorists, we do it ethically. If it wasn’t mined ethically, we wouldn’t have sales,” he stated.

Back to where we were, Sungail said that two years ago, the company was taking a look at the various AM markets, wondering which would be the best to participate in with its tantalum. Just like the above graph shows, GAM determined that its “value proposition was best in medical, and not automotive.”

“We realized we’d have to bridge the chasm between early adopters and later innovators. We’d have to teach the industry about tantalum and that it can be printed,” he said.

So the company got to work, using 200W and 300W lasers to 3D print medical devices like spinal implants and baseplates out of its tantalum; these fully dense parts are now in testing.

Sungail listed several reasons why tantalum is a good material to use in 3D printed medical devices – it resists blood clotting, so it can be used to fabricate stents, and its high surface friction, proven through several research studies done on animals, is good for implant stabilization.

Tantalum also has no problem with corrosion, which has been reported as being an issue with other implant materials. Sungail had a slide that showed a picture of a non-tantalum 3D printed hip implant, which required revision post-surgery due to corrosion; researchers determined that it was caused due to crevice (the oxygen effect) and galvanic (dissimilar metals). He explained that debris due to friction can lead to even more issues with implants, such as inflammation in the tissue around the joint, which can cause severe pain, and that cobalt chrome and Ti-64 implants can even lead to toxic effects, like bone degradation, if absorbed into the body.

“Tantalum doesn’t corrode in a normal body,” Sungail said. “Its only attacker is hydrofloric acid, and threading should also not occur with tantalum.”

Looking at the graph above, you can see that the material’s printability comes down to several factors, of which bioinertness combines several; Sungail explained that “these are generic combinations of various features for easy reading.”

“It’s significantly more printable than some other metals we use for medical devices,” he continued. “Tensile and elongation properties unfortunately aren’t well reported, so we turned to engineering handbooks for this informnation, and modulus can be tuned with this material. There are four to five papers out now from researchers who printed tantalum and made it 70-80% porous, because this is the sweet spot for osseointegration. They noticed that the elastic modulus exactly matched bone in this range.”

Sungail said that he’s been at many conferences where people have concurred that tantalum is a great material, but don’t know how to justify using it since it’s more expensive than Ti-64.

“That’s the wrong question,” he said. “Ask the cost to the patient.”

While looking for a well-documented surgical study, GAM found an example with a 3D printed transforaminal lumbar interbody fusion (TLIF) implant, which is shown in the slide below with the cost benefit example analysis.

“We looked at the whole process, buying the raw material and printing and cleaning it and sterilizing it, packaging, surgery, to the point where the patient walks out,” Sungail explained. “Tantalum’s contribution to this implant on the slide is .02%. I think that’s nearly negligible. Tantalum will allow the patient to walk out much quicker and recover much quicker.”

3D printing isn’t even the most expensive part of the whole process – it’s the surgery itself. If annual implant surgery revisions can be prevented by even 5% from switching to tantalum, the medical industry will save $300-500 million a year.

Another example Sungail shared was a 3D printed knee implant made out of tantalum. The surgery took place in China back in 2017, and the patient was actually able to stand up two hours post-op…that’s a pretty impressive feat.

Wrapping things up, he pulled up a slide showing GAM’s “current” tantalum products for 3D printing. In its angular powder form, the material works for cold spray technology and DED printing, while spherical powder can be used with laser AM technologies. He said that the company is also working on tantalum tungsten, and is “always looking for partners,” especially since GAM doesn’t have its own 3D printing system yet and relies on its partnerships to print tantalum for them. However, Sungail said they are considering a 3D printer purchase…perhaps this is an announcement we’ll see in the near future?

Stay tuned to 3DPrint.com as we continue to bring you the news from AMS 2020.

Discuss this and other 3D printing topics at 3DPrintBoard.com or share your thoughts below.

[Photos: Sarah Saunders]

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India: Researchers Continue to Review AM Processes in Bioprinting

In the recently published ‘A Review on Additive Manufacturing for Bio-Implants,’ authors Tajeshkumar R. Jadhav, Dr. Nitin K. Kamble, and Pradnesh R. Padave explore one of the most fascinating topics in 3D printing today as researchers make huge strides in developing medical devices with the use of innovative materials.

While some scientists are focused on the complex task of tissue engineering human organs, many others have made huge progress in the area of patient-specific treatment. This includes the development of devices like titanium bone implants, while others continue to develop new 3D printed prosthetics, dental and orthodontic implants, and more. In this review, researchers from Patil College of Engineering in Pune, India discuss scientific advances in the biomedical realm with digital fabrication.

As millions of patients are operated on daily, medical scientists, doctors, and surgeons are always exploring new ways to treat patients better. Tissue engineering and 3D printing are quickly moving to the forefront as one of the most innovative alternatives for tissue, bone, and organ regeneration, usually through the fabrication of scaffolding and other biocompatible structures used to promote growth. Additive manufacturing via extrusion is being used often with a wide range of materials to include polymers, inks, hydrogels, pastes, and more.

“While applications of bioprinting of oral tissues are still in early stages, this strategy has displayed interesting results in various preclinical studies and seems encouraging, progressing beyond templates and models,” state the researchers. “However, for successful clinical translation it is important to develop a road map, which includes studies to receive the required FDA approval and CE marking at an early stage in the process.

Additive rapid prototyping process diagram

Steps are being taken to create more safety and standardization guidelines, while also finding a balance with new developments and methods for making patient-specific treatment plans and customizations previously unheard of in medicine.

While the technology of 3D printing and additive manufacturing has already led to countless, groundbreaking inventions—some of which may substantially improve or even save lives—there are still many challenges to overcome; for instance, equipment is often out of reach financially, materials may be difficult to come by, and there are other complexities and inconveniences like processing and finishing issues.

Scientists use a variety of different methods today for the fabrication of bio-implants, to include:

  • Inkjet printing
  • 3D printing
  • Stereolithography
  • Selective laser melting
  • Bioprinting

Fused Deposition Modelling (FDM)

 

Three-Dimensional Printing (3DP)

“Currently, there are three main ways that cells can be printed on the implants directly, (i) Inkjet, (ii) Extrusion and (iii) Laser Assisted Based (LAB). Indirect printing technologies do not print biomaterials. Such methods are used mainly for the construction of scaffolds which are then used for the seeding of cells, drug delivery systems, potential biochips or biosensors,” state the researchers.

Users have many options to choose from today but must be aware of the pros and cons of each method of digital fabrication, as well as that of different software, hardware, and materials.

Stereolithography (STL or SLA)

Selective Laser Sintering (SLS)

Researchers are already working on both the macro- and micro-scale, however, learning more about how to manipulate larger materials as well as nanosized particles during in vitro studies.

“Direct fabrication of implants and prosthetics is however limited to the direct metal AM technologies that can produce parts using FDA (The US Food and Drug Administration) certified materials plus the small number of technologies that are capable of non-load bearing polymer scaffolds,” concluded the researchers.

“As more inter-disciplinary researchers are recruited into the field together with the advancement in biomaterials, it is likely that AM machines and techniques will be further improved over the years.”

What do you think of this news? Let us know your thoughts! Join the discussion of this and other 3D printing topics at 3DPrintBoard.com.

– Additively manufactured scaffolds for periodontal regeneration. (a)
Biphasic scaffold facilitating fiber orientation (b) Biphasic scaffold in
combination with cell sheet technology (c) Enhanced biphasic scaffold (d)
Triphasic scaffold (e) First additively bio manufactured scaffold for
periodontal regeneration applied in human

[Source / Images: ‘A Review on Additive Manufacturing for Bio-Implants’]

The post India: Researchers Continue to Review AM Processes in Bioprinting appeared first on 3DPrint.com | The Voice of 3D Printing / Additive Manufacturing.

AMS 2019 Day 3: Keynote Speaker Lars Neumann from TRUMPF Discusses 3D Printed Medical Devices

At last week’s second annual Additive Manufacturing Strategies (AMS) summit, held in Boston and co-hosted by 3DPrint.com and SmarTech Markets Publishing, there were several firsts, including an exhibition floor, a startup showdown, dedicated workshops, and two separate tracks for medical and dental 3D printing. During the official opening of AMS 2019, “The Future of 3D Printing in Medicine and Dentistry,” Lawrence Gasman, the President of SmarTech Markets Publishing, said that while last year’s event had participants from roughly 11 countries, this year 24 countries, along with 27 US states, were represented.

The first keynote speaker at AMS 2019 was Dr. Ali Tinazli, the Head of Healthcare and Life Sciences Strategy for HP; he discussed the democratization of medicine and the implications of this. On the final day of the summit, Lars Neumann from German machine tool supplier TRUMPF took the stage for the final keynote presentation, titled “Integrating Additive Manufacturing Into Medical Device Production” and centering around 3D printed instruments and implants.

Neumann, who works at the company’s south German location, explained that TRUMPF is a family business, and that after 90 years in the manufacturing business, it has “quite a bit of a track record” in the medical field, noting examples like using lasers to cut stents.

“If there are any doctors here, typically I’m not talking to you…my presentation today is the production of these devices,” Neumann stated at the beginning, explained that he was mostly talking to the medical device manufacturers.

Neumann noted that in the previous days at the summit, attendees had seen and heard lots of numbers, and said that he was going to be “looking at growth, more than the actual numbers.”

Speaking of those numbers, he mentioned that growth rates for 3D printed medical devices were around 10-15%, which is “quite a significant growth year on year.” But when it comes to fusion devices, Neumann said that people in the industry believe that additive manufacturing will be used 100% in the future.

Some of the main things Neumann said we need to keep discussing to allow serial additive manufacturing to become economically viable for more implants and devices include system and process capability, cost per part, and quality assurance, as “driving up quality lowers cost.”

But how can we assure quality when it comes to 3D printing? Neumann said lots of input, such as CAD data, are necessary when attempting to fabricate a medical device that fulfills all of its defined specifications, since the regulations and standards (like ASTM and ISO) aren’t complete yet. While the lengthy old guard of quality assurance centered around manually maintaining the quality of inputs, like powder, during 3D printing and post-processing and then again checking the completed product, now that imaging equipment and sensors are being added to help ensure quality during the build, we can ideally intervene, if necessary, during the actual 3D printing process.

It’s equally as important to lower the cost per part. In manufacturing environments, such as factory floors, ideally the 3D printers should be working on builds around the clock, instead of having to take time for set-up and cleaning. Neumann said that to help ensure this notion, laser off times need to be reduced, and that all other processes, such as post-processing, should be moved to different locations so that the printers can just keep doing what they do.

In terms of system and process capability, Neumann asked the room what the industry could be doing better to arrive at not only different implants, but also more of them. His personal impression is that, since the additive manufacturing field is developing so quickly, process chain integration is one of the main topics at the moment, along with software, and that machine technology will need to be pushed again a few years down the road.

Neumann stated that in terms of additive manufacturing, the main medical device categories are:

  • standardized implants
  • personalized implants
  • medical instruments
  • non-implantable devices

He also noted what he called “three key advantages” for 3D printing in the medical field: mass personalization, which provides new treatment options; using porous structures to improve osseointegration; and cost-effective manufacturing, such as low- to mid-volume, less expensive materials, and the ability to create complex shapes. Neumann said that this last point is “slowly coming into focus,” because when it comes to medical 3D printing, hundreds of thousands of parts are not always needed, which can definitely help keep costs down.

Because of increased interest by medical device manufacturers to use 3D printing, Neumann believes that instrumentation as an application will definitely grow, and mentioned that about 100 3D printed medical devices are already FDA-approved.

Switching the focus to the metals used to 3D print many of these instruments and devices, Neumann said that while many people have been excited about titanium in recent years, new materials like cobalt chrome and stainless steel are the talk of the town at this point in time. With a nod to one of his previous points, he also brought up how preheating implants 3D printed with Ti64ELI can affect the overall quality of the final component by ensuring less distortion. Neumann said that more information on this will come from TRUMPF later in the year, but did note that in the future, it may no longer be necessary to use as much heat treatment, which also helps lower costs.

Finishing up, Neumann said that aerospace companies are the only ones that possess guidelines to follow when installing metal 3D printers, and that it would be helpful if this would eventually spread to other sectors as well, such as the medical field.

“I hope someday this norm is valid for all industries equally,” Neumann stated.

Some of the questions asked at the end of Neumann’s keynote were quite interesting. One person approached the mic and asked his opinion on the currently available simulation tools, and Neumann said that the software is interesting and seeing a lot of investment at the moment, as many companies, such as OEMs, that use 3D printing are running simulations ahead of nearly every component they’re manufacturing in order to predict defects early on. But, he also noted that the data coming from these simulation solutions has yet to be validated.

Another attendee mentioned again the demand for new, exotic materials in medical instrument 3D printing, and asked Neumann for any specific examples. While it may not sound exotic, he said that stainless steel is one material that many manufacturers can use without having to change the production or post-processing methods, meaning that re-certification won’t be required, so lead times will likely decrease.

Plans have already been laid in motion for the third annual Additive Manufacturing Strategies summit, which will be held from January 29-30, 2020 and will include a metal 3D printing track. To keep up to date on registration information and everything else for AMS 2020, sign up for our newsletter here.

Discuss this news and other 3D printing topics at 3DPrintBoard.com or share your thoughts in the comments below.

[Images: Sarah Saunders]

Australian Woman Receives 3D Printed Jaw Implant After Tumor Removal

Anelia often wore a mask to help deal with the self-consciousness of her initial jaw surgery.

3D printing continues to lead the medical field to new heights, and while this is a boon for scientists, surgeons, and progressive technology—patients are often the ones emerging as the real winners. Anelia Myburgh can attest to this as she was recently the recipient of a 3D printed jaw implant. And while so many implants today are responsible for improving the quality of life of patients, Myburgh was particularly grateful to have a chance for facial reconstruction.

A native of Melbourne, Australia, Myburgh lost much of the lower portion of her jaw and teeth when surgeons were forced to remove them due to a dangerous tumor (originally discovered when she began complaining of a small bump); in fact, 80 percent of her jaw area was removed due to the cancer doctors found within—leaving her with only a couple of teeth and a significantly disfigured face. They saved her life, but the tumor-removal surgery did not come without a physical and emotional toll also.

Myburgh was understandably self-conscious about being in public after the surgery removing the tumor. She was not alone in such struggles either as so many other cancer patients around the world who have had similar jaw surgery are left with challenges such as adapting to a new and often less attractive physical demeanor—along with having difficulty in chewing and eating.

“I just want to be able to walk down the street and not have people stare,” said Myburgh before the 3D printed jaw was implanted. “That is my ultimate goal.”

Medical professionals demonstrate how the 3D printed jaw will work.

Her greatest hope was that with the 3D printed implant, her countenance would be more normal once again, and the surgical team was confident beforehand.

“The fact that we can 3D print a frame where we can actually anchor some teeth back for her would give her back her quality of life,” said her maxillofacial surgeon, Dr. George Dimitroulis.

Many medical appointments were necessary with the surgical team before Myburgh went in to the operating room.

The surgery to implant the new 3D printed jaw and titanium frame took five hours and included taking extra skin from her forearm and diverting it to her lip area to help with normalizing her facial area again. Such a procedure would cost around $22,000 in US dollars. It was a huge success for Myburgh though, who now has a full set of new teeth and reconstructed lips. And while her bravery and beauty certainly shine from within, there is no denying that the 3D printed jaw allowed her to return to her former attractive self. Not only that, now she can enjoy the joy of cheeseburgers again!

What do you think of this news? Let us know your thoughts; join the discussion of this and other 3D printing topics at 3DPrintBoard.com.

[Source / Images: 1NewsNow; Inside Edition]

Anelia sees her new face for the first time.

Optomec Introduces New Hybrid 3D Printing System, Used By Researchers to Make Dissolvable Magnesium Medical Implants

New Mexico-based Optomec is well-known for both its aerosol jet technology, which is used to 33D print electronics, and its other patented AM process: LENS, which uses Directed Energy Deposition (DED) for high-value metal 3D printing. The company has been busy in the last few years, winning contracts and awards and providing resources on its technologies. In 2016, the company first showcased its hybrid LENS Machine Tool series, which consist of a CNC Vertical Milling platform integrated with Optomec’s proprietary LENS metal 3D printing technology.

This week at IMTS 2018 in Chicago, Optomec is introducing the latest addition to the series – the LENS 860 Hybrid Controlled Atmosphere (CA) System.

“The new LENS 860 suite of systems builds on the success of our Machine Tool Series, first launched at IMTS in 2016,” said Dave Ramahi, Optomec President and CEO. “These new larger machines continue to demonstrate our ability to transition Optomec production-proven 3D Metal Printing capability onto traditional CNC platforms that match the cost, performance and ease-of-use demands of the traditional machine tool market. These products are a key element of our strategy to bring Metal Additive Manufacturing into the industrial mainstream.”

The new large-format LENS 860 Hybrid CA System offers more capabilities for high-quality, affordable metal hybrid manufacturing, thanks to its higher laser power support and larger build volume of 860 x 600 x 610 mm. It features a hermetically-sealed build chamber that maintains moisture and oxygen levels below 10 ppm for processing reactive metals, like titanium, and can cost-effectively produce and repair parts.

The system offers versatility, as it can perform wide area cladding for wear coating applications and 3D print fine, detailed features for thin wall metal structures. It can also be configured with a high-power 3kW fiber laser and closed loop controls, which makes it the perfect choice for building, repairing, and coating mid- to large-size parts that offer superior metal quality. Optomec’s powerful software allows for 5-axis build strategies, which can combine both subtractive and additive operations in one tool path; the company also provides several material starter recipes to speed up adoption with the LENS 860 Hybrid CA System.

Performing finish machining on a 3D printed part with the LENS Hybrid configuration’s milling capability, without having to align it on another machine or re-fixture it, is one of the many advantages of the LENS Machine Tool Series, which start at under $250,000. There are three additional configurations to the LENS 860 Hybrid CA System model in the series: two Additive-Only models, both of which are Open and Controlled Atmosphere, and and the 860 Hybrid Open Atmosphere (OA) system, which is a good platform to use when processing non-reactive metals like Tool Steel Inconel and Stainless Steel.

You can see the new system for yourself this week at Optomec’s booth #432204 in the West Building at IMTS 2018. The first customer shipments of the LENS 860 Hybrid CA System will take place later this year.

Speaking of customers, Optomec also shared the details at IMTS of how the University of Nebraska-Lincoln (UNL) is using one of its new LENS Hybrid CA Systems to create dissolvable magnesium components for applications in the medical field.

Medical implants, like screws and plates, made of stainless steel or titanium, are permanent structures that can have high complications rates and need to be surgically removed and fixed. But the university’s work with the LENS Hybrid CA System will allow the creation of 3D printed, patient-specific implants with a controlled time to dissolve, which will lower the costs, risks, and suffering of patients who will no longer require a second surgery to remove implants.

Professor Mike Sealy of UNL and his team are using an Optomec LENS Hybrid CA System to advance the performance and functionality of medical implants.

“We are proud to be the first customer of an Optomec LENS Hybrid Controlled Atmosphere System, the only commercially-available machine to provide hybrid manufacturing capabilities for reactive metals. Our research is focused on advancing the performance and functionality of dissolvable devices. Using LENS, we are applying a hybrid additive manufacturing process to control the disintegration of medical fasteners and plates so they stay in-tact long enough to serve their purpose and then degrade away once the bone is healed,” said Dr. Michael Sealy, Assistant Professor of Mechanical and Materials Engineering at UNL, and a pioneer in advanced manufacturing research.

Optomec’s LENS 3D Hybrid CA System is the AM industry’s first atmosphere-controlled system for additive and subtractive processing of metals, and combines the company’s industry-proven LENS technology with a strong CNC automation platform. The system will make it more cost-effective to introduce metal 3D printing to industrial markets.

The UNL is a 3D printing and hybrid AM leader, and using the LENS Hybrid CA System allows Dr. Sealy and his team to combine layered surface treatments with LENS technology in order to 3D print magnesium components with controlled degradation – a coveted design capability in the medical field, in addition to areas like automotive structures and lightweight aerospace. Whereas dissasolvable and bioabsorbable 3D printed polymers have been shown dissovable metals is completely new.

“Two years ago, at IMTS in 2016, Dr. Sealy and his team at University of Nebraska became the first customer of our LENS Hybrid Controlled Atmosphere system. Today they are here at IMTS showcasing their groundbreaking accomplishments achieved with their LENS Hybrid system,” said Tom Cobbs, LENS Product Manager at Optomec. “Dr. Sealy’s pioneering work enables the design and manufacture of components with a combination of properties unobtainable using traditional metal working methods.  We applaud his innovative use of hybrid additive manufacturing to create and qualify a new class of metal components with unique properties that will benefit mankind.”

Dr. Mike Sealy and UNL students have been using a LENS metal hybrid AM system from Optomec to advance research in key areas such as heavy machinery, medical devices, and aeronautics.

Reactive materials and powdered metals, such as titanium and magnesium, have to be processed in a controlled atmosphere, where oxygen and moisture impurities can be kept below 10 parts per million. Dr. Sealy used the Optomec LENS 3D Hybrid CA System to process these kinds of materials in a way that allowed a degradable implant to hang onto its integrity and strength long enough to complete its job. He is also working with Sentient Science to investigate hybrid processing techniques of 7000 series aluminum for the US Navy.

Discuss this and other 3D printing topics at 3DPrintBoard.com or share your thoughts below. 

[Images provided by Optomec]

Patient-Specific 3D Printed Spinal Solutions by Anatomics

3D printed anterior cervical cage

Australian medical device company Anatomics has a very prolific 3D printing portfolio in the healthcare industry, from assisting with a 3D printed heel bone to 3D printing the first titanium sternum and set of ribs and vertebrae. Anatomics founder Paul D’urso, MD, a neurosurgeon at Epworth Healthcare, began his medical 3D printing research way back in 1991, four years before starting the not-for-profit Anatomics, which has since helped over 5,000 patients with its custom 3D printed medical solutions.

D’Urso said, “Anatomics has lead the world in custom 3D printed spine technology for over 20 years and is proud to have developed numerous world first applications.”

3D printed occipito-cervical plate

D’Urso has a particular interest in developing spinal applications for biomodeling, and at the recent 3DHEALS conference in San Francisco, reported that he’s used 3D printing in nearly 700 spinal fusion procedures, including what D’Urso tells us is “the world’s first custom occipito cervical plate.”

“In the future Anatomics plans to create disruptive Spinal Solution Centres that will enable Community Based Personalised Healthcare allowing surgeons and hospitals to 3D print a range of spinal implants and share designs through-out the world,” D’Urso told 3DPrint.com.

The success of some of the innovative 3D printed solutions that D’Urso and Anatomics have developed, including 3D printed custom spinal implants, have recently been described in articles and research papers printed in various publications, such as the European Spine Journal and the Journal of Clinical Neuroscience.

The latter paper, titled “Designing patient-specific 3D printed devices for posterior atlantoaxial transarticular fixation surgery,” discussed how biomedelling and 3D printing are both useful tools for pre-surgical planning, developing titanium implants and patient-specific tools, and intraoperative stereotaxy – a minimally invasive surgical procedure which uses a 3D coordinate system to locate small targets inside the body and then perform an action, like an ablation, biopsy, injection, or implantation, on them.

The abstract reads, “Atlantoaxial transarticular screw fixation is an effective technique for arthrodesis. Surgical accuracy is critical due to the unique anatomy of the atlantoaxial region. Intraoperative aids such as computer-assisted navigation and drilling templates offer trajectory guidance but do not eliminate screw malposition. This study reports the operative and clinical performance of a novel process utilising biomodelling and 3D printing to develop patient specific solutions for posterior transarticular atlantoaxial fixation surgery. Software models and 3D printed 1:1 scale biomodels of the patient’s bony atlantoaxial spine were developed from computed tomography data for surgical planning. The surgeon collaborated with a local medical device manufacturer using AnatomicsC3D to design patient specific titanium posterior atlantoaxial fixation implants using transarticular and posterior C1 arch screws. Software enabled the surgeon to specify screw trajectories, screw sizes, and simulate corrected atlantoaxial alignment allowing patient specific stereotactic drill guides and titanium posterior fixation implants to be manufactured using 3D printing. Three female patients with unilateral atlantoaxial osteoarthritis were treated using patient specific implants. Transarticular screws were placed using a percutaneous technique with fluoroscopy and neural monitoring. No screw malposition and no neural or vascular injuries were observed. Average operating and fluoroscopy times were 126.0 ± 4.1 min and 36.7 ± 11.5 s respectively. Blood loss was <50 ml per patient and length of stay was 4–6 days. Clinical and radiographic follow up data indicate satisfactory outcomes in all patients. This study demonstrates a safe, accurate, efficient, and relatively inexpensive process to stabilise the atlantoaxial spine using transarticular screws.


The paper also explained how operative ergonomics and the placement of atlantoaxial transarticular screws can both be simplified using 3D printing. Authors include Ganesha K. Thayaparan, with Epworth’s Department of Neurosciences, and Anatomics’ Mark G. Owbridge, Robert G. Thompson, and D’Urso.

Discuss this and other 3D printing topics at 3DPrintBoard.com or share your thoughts in the comments below. 

[Images provided by Anatomics]