Chris Cahill spent two months in a coma. The 35-year-old from New Brunswick, New Jersey woke up confused. He didn’t know where he was. Or what happened to him.
Cahill was found unconscious from physical trauma. Severe injuries to his frontal lobe left his brain swelling in a life-threatening situation. Dr. Gaurav Gupta brought down the swelling with an emergency surgery. After the surgery, Dr. Gupta knew he had to replace the skull where the injury occurred. But Cahill’s skull was infected. It couldn’t be used to set up a metal mesh to replace that part of the skull. So Dr. Gupta turned to 3D printing to save Cahill’s life a second time.
The Innovative Doctors
3D technology is already being used in medical applications. But in March, Dr. Gupta, assistant professor of neurosurgery at Rutgers Robert Wood Johnson Medical School, did something new. He successfully implanted a 3D printed skull bone into Cahill’s head.
Dr. Gupta worked with Johnson & Johnson’s DePuy Synthes to create the 3D printed skull implant. First, the doctor used a CAT scan to 3D print a replica of Cahill’s skull. Then, he says, “Once the skull implant was printed, millimeter by millimeter, we matched the new implant to the skull model, ensuring a perfect fit.”
The doctor needed to create two separate implants because of the size of the skull. However, Dr. Gupta was able to bond the two skull bone pieces together.
Before the surgery could begin, Cahill needed additional skin grown on his head to cover the implant. Dr. Gupta tapped Dr. Tushar Patel, plastic and reconstructive surgeon and partner at The Plastic Surgery Center in Shrewsbury. Dr. Patel inserted a tissue expander that allowed Cahill’s head to grow skin. The doctors made the incisions behind Cahill’s hairline, so Cahill has no visible scars.
Cahill says, “I was nervous about what I would look like after the surgery. I was happy and I looked exactly the same and felt like myself again.”
The Technology Behind the 3D Printed Skull Implant
The material used for the implants was polyetheretherketone (PEEK). PEEK is highly stable, strong, and biocompatible with bone. The metal mesh that surgeons usually use is weak and lacks precision. The custom capabilities of 3D printing allow for high precision and strength in implanting objects into the human body. Implants are also frequently impact-resistant and fracture-resistant. With Cahill’s significant and irregular skull damage, 3D printing was possibly the only solution that could execute so smoothly.
Dr. Gupta says that PEEK is inert; it does not cause inflammation, allergic reactions, or bodily rejections. PEEK also does not erode or dissolve.
New Jersey-based Dr. Gupta is also director of cerebrovascular and endovascular neurosurgery at Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital. And, he says, “ten years ago, we could not even think that we would be using this technology. However, we certainly always had the need for it.”
Dr. Gupta believes it is immensely important to use 3D printing with caution: on the right patient, for the right procedure. “One part, one technology, and one technique will not fit all,” he says. “It has to be custom-tailored to the patient’s well-being.”
Future Uses of 3D Printing in Medicine
Dr. Gupta does not believe 3D printing has reached its full potential in the medical field yet. From his perspective, he says, 3D printing is in its infancy.
He says, “It’s such a new area and everybody’s very excited about it, and everybody likes to use the words 3D, 3D printed body parts. But it must be understood that this is not a magic new substance that will increase your life or the fountain of youth.”
But 3D printing in the medical industry is nothing new. Gupta says what’s most exciting to him is that 3D printing marks a new era in medicine. Gupta predicts the standardization of 3D printing across all of medicine, except the material used in each specialty will be different.
“This is indeed a very exciting time. A time when the merging of the body’s own tissues and devices that human beings have created can prolong our lives and make us more comfortable and disease free.”
“A lot of researchers are using parts to make tissue, skin, muscles, blood vessels. However, the material used for printing skin, muscles, and any other tissue has to be the appropriate material, which is most likely other skin cells,” he says. “There will be better cures for the diseases we are troubled with today, and for the diseases that are not cured, we will be able to offer solutions to live with those diseases more comfortably.”