Lumbosacral plexus 3D printing with dissection validation - a baseline study with regards to lateral spine surgery

Abstract

Objective: Neurological complications are the most common complications in lateral spine surgery.The aim of this study was to determine the feasibility and anatomical accuracy of a 3D reconstruction and printed model of the lumbosacral plexus with regard to lateral spine surgery. Methods: We performed 3 T-MRI scans of two fresh frozen cadavers (A&B). The scans were processed by ©axial3D (Belfast, Northern Ireland, UK) facilitating stereolithography to create a 3D printed model of the lumbosacral plexus. Subsequently both cadavers were dissected on to assess the anatomical courses of the lumbosacral plexus. Results: The 3D model of the lumbosacral plexus of cadaver A corresponded to the anatomical features of the dissection and impressively portrayed the individual nerve branches with regard to LLIF at the relevant disc levels. Due to advanced decomposition, no data could be obtained from the MRI of cadaver B that would have made 3D printing possible. However, the dissection of cadaver B revealed the configuration of nerve fibers running within the muscle tissue that are at risk during the approach. Conclusion: From a scientific point of view, the 3D rendering process used for this study resulted in a precise 3D model of the desired structures in a well-preserved cadaver. However, the production process must undergo further in-vivo validation and automation with regard to the software, in order to develop clinical value in daily use.

Keywords

• 3D
• XLIF
• LLIF
• Spine
• Lumbar
• Plexus