Personalised rods may improve outcomes, cut surgery time

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Advances in medical imaging and implant manufacturing are making it possible to tailor an implant to the patient receiving it, according to a press release from Rush University Medical Center, Chicago, USA.

Matthew Colman has begun using patient-specific rods in reconstructive surgery — giving patients with spinal deformities implants designed to fit their anatomy perfectly. An assistant professor of orthopaedic surgery at Rush, Colman is a spinal surgeons also specialising in spine cancer treatment. He was one of the first doctors in Chicago to use these patient specific rods.

Customisation is done in advance of procedures in cooperation with an implant manufacturer. To create customised rods, Colman uploads the patient’s calibrated X-rays to a computer. Then, he uses a software program to plan the reconstructive surgical procedure.

The software allows him to simulate deformity correction and other surgical manoeuvres in order to map out and determine the exact length and shape of the rod. The specifications are sent to the manufacturer, and the finished rod is delivered to Rush.

Because so much of the planning is done before surgery, less time is needed during the operation itself. “When we reduce time operating room we help to decrease the chances for infection and blood loss during surgery—and we decrease potential mistakes with the measurements,” Colman says. “In addition, manipulating the rod by hand-bending them may cause them to break more easily, which is theoretically avoided with the custom manufacturing process.”

In addition to custom-made spinal rods, Colman has also been involved in the design of patient-specific 3D printed vertebral cages, which are used to provide anterior (frontal) support for spinal reconstructions when the area in front of the spine has been destroyed or removed due to infection, a tumour or trauma. The cages are in the process of receiving US Food and Drug Administration approval for use in the USA, according to the press release.

“The future of implants is in customisation,” Colman says. “New technology is streamlining the process, making surgery more efficient and effective by employing faster and better working methods.”