Idiopathic Scoliosis

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A patient with severe idiopathic scoliosis, experiencing shortness of breath, fatigue, and discomfort, was referred to the 3DQ Lab for preoperative evaluation. Imaging revealed not only a significant spinal curvature but also the presence of hardware from previous corrective surgeries. These surgeries, aimed at stabilizing the spine, involved placing metal rods and screws, but over time the curvature continued to impact lung function, leading to the patient’s current symptoms.

In cases of severe scoliosis, the spine’s abnormal curvature can compress the lungs and restrict their ability to expand fully, causing breathing difficulties. The body’s effort to compensate for the spine’s misalignment can also lead to fatigue, as maintaining balance requires more energy. For this patient, the combination of spinal deformity and prior hardware complicates the surgical planning, requiring further imaging and a 3D printed model.

The main challenge in this case stemmed from the previously installed spinal hardware. The metal caused significant streaking artifacts in the CT imaging, making it difficult to differentiate between the artifacts and bone structures. This was further complicated by the severe spinal deformities. Ultimately, the 3D Lab was able to provide imaging including those seen below.

The surgeons also requested a 3D-printed model of the patient’s spine, including the spinal cord, which introduced additional complexity. They requested that the anatomical details should be taken from a recent MRI scan rather than the CT. However, since the CT and MRI scans were performed with the patient in slightly different positions, the anatomy couldn’t be directly aligned. To address the difference between the scans, our 3D technicians manually aligned them using bony landmarks as reference points. They then adjusted the vertebrae in 3D modeling software, rotating them as needed with guidance from a spinal surgeon, ensuring the model’s accuracy despite positional differences between the scans.

The 3D model was printed using stereolithography (SLA) technology, which uses a laser to cure liquid resin layer by layer providing heightened accuracy. The model was created in a clear material at the request of the surgical team.