Evaluation of radiological data for three-dimensonal physical models to assist personalized anesthesia in neuroaxial interventions with difficult anatomy

The objective of this study is to compare conventional anesthesia practices with the use of a preoperative, personalized, life-sized three-dimensional (3D) physical spine model in individuals where neuroaxial anesthesia is anticipated to be challenging due to difficult anatomy as difficult anatomy as the presence of spinal segment fusion, reduced spinal mobility and flexibility, joint stiffness, and movement restriction in the lumbar spine. Twenty individuals aged between 30 and 90, who were expected to undergo neuroaxial anesthesia with a difficult anatomical profile, and who had completed preoperative radiological evaluations, were included in the study. Radiological data were processed using Z-Suite software and printed as solid models with a Zortrax M300 3D printer. The individuals were randomly assigned to 1 of 2 groups: a conventional anesthesia group (n = 10) and a 3D model-assisted anesthesia group (n = 10). The number of successful attempts during epidural/spinal anesthesia procedures was recorded and compared between the 2 groups. The cost of producing each 3D spine model was calculated at $10, using 340 grams of material, with a printing time of 2 days and 11 hours per model. In the 3D model-assisted group, the success rate for anesthesia was 100%, while the success rate in the conventional group was 80%. The first-attempt success rate in the 3D model-assisted group was 80%, compared to 20% in the conventional group. In the conventional group, there were instances where successful anesthesia was not achieved even after 3 or more attempts. The use of 3D models improved the success of epidural/spinal anesthesia in individuals with challenging spinal anatomy during limb surgery. We conclude that 3D modeling can increase the success rate of anesthesia in cases where difficult neuroaxial anatomy is anticipated, potentially reducing the risk of complications associated with multiple attempts.