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. 2017 Dec;3(4):572-579.
doi: 10.21037/jss.2017.10.07.

Use of 3D printer model to study vertebral artery anatomy and variations in developmental craniovertebral junction anomalies and as a preoperative tool-an institutional experience

Sachin Chhabra  1 , Sanjeev Chopra  1 , Rashim Kataria  1 , Virendra Deo Sinha  1
Affiliations

Use of 3D printer model to study vertebral artery anatomy and variations in developmental craniovertebral junction anomalies and as a preoperative tool-an institutional experience

Sachin Chhabra et al. J Spine Surg. 2017 Dec.

Abstract

Background: Spinal instrumentation using rods and screws have become procedure of choice for posterior fixation. Vertebral artery anatomy is highly variable in this region posing challenges during surgery. Our study used 3D printer model to understand the anatomy and variations in vertebral artery in live patients thereby providing an accurate idea about vertebral artery injury risk in these patients preoperatively and to rehearse the whole procedure.

Methods: Ten patients of developmental craniovertebral junction (CVJ) anomalies who were planned for operative intervention in the Department of Neurosurgery at SMS Hospital from February 2016 to December 2016 were analysed using a 3D printer model.

Results: Out of twenty vertebral arteries studied in ten patients, two were hypoplastic and out of these one could not be appreciated on 3D printer model. Out of remaining nineteen, thirteen arteries were found to lie outside the joint, three were in lateral third, one traversed the middle third of joint and one lied in medial third. In one patient, the vertebral artery was stretched and it traversed horizontally over the joint. Out of ten patients studied, nine were having occipitalised atlas and so entry of these vertebral arteries into cranium were classified as given by Wang et al. into four types.

Conclusions: By our study, 3D printer model was extremely helpful in analyzing joints and vertebral artery preoperatively and making the surgeon acquainted about the placement and trajectory of the screws accordingly. In our opinion, these models should be included as a basic investigation tool in these patients.

Keywords: 3D printer; craniovertebral junction (CVJ); vertebral artery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Showing 3D printer prototype model with left vertebral artery over the lateral part of joint and normal entry into cranium.
Figure 2
Figure 2
Showing left atlantoaxial joint dorsally with vertebral artery lying outside the joint and distances being measured by malleable wire.
Figure 3
Figure 3
Showing the medial displacement of vertebral artery on right side with left artery outside the joint.
Figure 4
Figure 4
(A-D) Showing preoperative rehearsal of instrumentation on 3D printer model.
See this image and copyright information in PMC

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