From imaging to reality: 3D printing for craniopagus twins separation, a technical workflow and a center experience.

BACKGROUND

Craniopagus twins pose a unique surgical challenge because of complexity in shared cranial and vascular anatomy. Recent development in technology seems to have potential in assistance in pre-surgical planning, by providing patient-specific physical models of complex anatomy. To date, the application of 3D-printed models for craniopagus twinning separation has not been reported in Saudi Arabia or in the wider Middle East.

OBJECTIVE

This descriptive study describes the process and establishes the use of 3D-printed anatomical surgical models for the pre-surgical planning of three recent cases of craniopagus twin separation performed at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia. These models are the first of their kind in the country and are a major milestone in neurosurgical planning.

METHODS

High-resolution MRI and CTA imaging data were collected for three cases of craniopagus twins. The imaging data were segmented and processed to create 3D models of the skull, brain, and shared vasculature using specialized software. Multi-material 3D printing was then employed to produce physical models that accurately represented different anatomical structures, allowing for enhanced distinction and visualization.

RESULTS

Three sets of 3D-printed models were successfully developed. The 3D-printed models provided an accurate and detailed representation of the shared anatomy, allowing the surgical team to visualize and manipulate the complex cranial fusion points and vascular connections. The models were particularly valuable in reducing intraoperative uncertainty and mitigating the risk of complications. This is the first documented use of 3D printing for craniopagus twin separation in Saudi Arabia.

CONCLUSION

As the first such application in the region, this study paves the way for broader use of 3D printing in complex neurosurgical cases across Saudi Arabia and the Middle East. Further research is needed to explore the full potential of this technology in enhancing clinical outcomes.