Born in Bologna in 1967, Dr. Alessandro Gasbarrini graduated in 1992 in Medicine and Surgery from the University of Bologna, where he continued his training, specializing in Orthopedics and Traumatology in 1997. He deepened his knowledge of spinal pathologies through numerous training periods in Italy and abroad (IOR Bologna; CTO Florence; CTO Strasbourg; Chu de Bordeaux; MedtronicSDMemphis, Tennessee, USA and Spine Center Dartmounth, New Empshire, USA). In the course of these experiences he has refined his studies in Orthopedic Oncology with emphasis on Vertebral Oncology, Degenerative Vertebral Pathology, Biologic and Minimally Invasive Reconstruction in the Spine. His articles have been published in leading scientific journals in the field and he has participated as a speaker in national and international congresses. He is currently Director of the Complex Structure of Vertebral Surgery at the Rizzoli Hospital in Bologna.

If astronauts in space use 3D printers to build useful tools for the crew as well as spare parts, why don't we doctors on earth do the same? It is thanks to this insight that Alessandro Gasbarrini, Director of Oncologic and Degenerative Vertebral Surgery, began using the rapid prototyping technology to make prostheses in Able to replace damaged vertebrae from tumors. An idea carried out together with the Rizzoli Orthopedic Institute where an excellence of Italian healthcare works, where man is at the center and the union of clinic and research allows doctors to dare until they find the best treatment specific to each individual patient.

3D printing was born in 1986, when Charles "Chuck" Hull invented stereolithography and founded 3DSystems, a company that gave birth to the first commercial example of rapid prototyping. From then to the present day, many strides have been made and the areas of application of this technology range from the manufacturing industry to the automotive, defense, and mechanical engineering sectors, to name a few. In health care, 3D printers have long been used for surgical planning. For example; anatomical models of patient parts are created so that the surgeon can study them, simulate surgery and practice cuts and movements. This is a team effort where the key word is synergy between the radiologists who provide the images, the biomedical engineers who make the model, and the surgeons. The latest application frontier concerns the creation of real "replacement prosthesis" built to measure for the person.

"The vertebra is a piece of what constitutes the backbone of the human body," stresses Alessandro Gasbarrini, who adds, "Because of its vascularity, it is also one of the favorite sites for tumors to develop. When a tumor attacks the bones of the spine, the vertebrae that have become diseased must be removed. There are a thousand ways to replace a vertebra, our intuition started from the consideration that we already have an incredible amount of data available on the specific vertebrae, following, for example, the performance of a CT scan. These data, In the hands of biomedical engineers, Are used to reconstruct in biocompatible material, for example titanium, exactly the vertebra removed With a trabeculature even very similar to that of bone."

To pursue this insight, Dr. Gasbarrini created from scratch a team of professionals capable of managing the various steps to implement this innovative technology. The first step is the performance of specific examinations, e.g., MRIs, CT scans, X-rays, which help to understand how to implement the reconstruction. After that, the information is sent to engineers, who use computers to reconstruct the patient's physiognomy and prostheses. Then the design is examined and adapted to the specific needs of the medical team and the patient, and materials and shapes are defined. The last step is consent for fabrication by 3D printing.

SOME GOOD STORIES

Our protagonist is 15 years old and, as a child, a nasty tuberculosis attacked her lungs extending to her spine. The Apulian family hosting her during the summer contacts Dr. Gasbarrini through the Probone Foundation, which provides care and treatment for people with spinal and musculoskeletal disorders in order to improve their quality and dignity of life. After prolonged antibiotic therapy, the infection is eradicated, but it has affected and destroyed the vertebrae of the dorso-lumbar passage, which have welded into the deformity and, compressing the spinal cord, cause out-of-control pain and threaten leg paralysis. The operation to remove the wedged vertebra and replace it with a titanium prosthesis takes 8 hours, But at its end, the spine is straight and the spinal cord fully functional. So much so that, only a few months later, V. B. sends the doctors who treated her a video of her happy and smiling as she runs along the beach.

Another story that has the unbelievable is that of Ryan, who in 2015 became ill with Ewing's sarcoma, a malignant bone tumor that consumed a vertebra in his spine, causing compression paraplegia. Paralyzed, he could not hold his head up off his neck. For doctors, there was almost no hope of him walking again. On June 14, he was operated on for 12 hours by the spinal surgery department of the Rizzoli Orthopedic Hospital in Bologna, led by Alessandro Gasbarrini and Alessandra Longhi. A surgery that was meant to stabilize the boy and at least give him the ability to sit up, but mom helps him with physical therapy and Ryan is now able to walk. "The outcome of the surgery this patient underwent is extraordinary"-Dr. Gasbarrini says happily. "We merely removed the diseased vertebra and replaced it, then he and his family performed the miracle!"

AND FOR THE FUTURE?

3D printing is a fascinating technology, but as Dr. Gasbrarini points out, Medically, the optimum would be a replica in bone tissue: this is the next challenge!

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