Evidence map›Paper›PMID 37351673›Full record

ArticleActa neurochirurgica2023

Toward global availability of low-cost, patient-specific cranial implants: creation and validation of automated CranialRebuild freeware application.

Alice Xu, Vysakh Venugopal, Manish Raj Aryal, Yara Alfawares, Abhijith V Matur, Joshua Cheng, Ethan Kosco, Matthew McConaha, Omkar Ghalsasi, Demiah Lockett and 5 more

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In one paragraph

Article in Acta neurochirurgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Alice XuUniversity of Cincinnati College of Medicine, Cincinnati, OH, USA.
Vysakh VenugopalCenter for Global Design and Manufacturing, Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH, USA.
Manish Raj AryalCenter for Global Design and Manufacturing, Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH, USA.
Yara AlfawaresUniversity of Cincinnati College of Medicine, Cincinnati, OH, USA.
Abhijith V MaturDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Joshua ChengDepartment of Biomechanical Engineering, Duke University, Durham, NC, USA.
Ethan KoscoDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Matthew McConahaCenter for Global Design and Manufacturing, Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH, USA.
Omkar GhalsasiCenter for Global Design and Manufacturing, Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH, USA.
Demiah LockettUniversity of Cincinnati, Cincinnati, OH, USA.
Gabriella BalUniversity of Cincinnati College of Medicine, Cincinnati, OH, USA.
Norberto AndaluzDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Laura B NgwenyaDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Sam AnandCenter for Global Design and Manufacturing, Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH, USA.
Jonathan ForbesDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA. forbesjh@ucmail.uc.edu.
University of Cincinnati Medical Center · USUniversity of Cincinnati · USDuke University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFinancial restrictions limit the options for hermetically precise, patient-specific cranial implants (PSCIs) after decompressive hemicraniectomy (DHC) in low-income countries. Use of image segmentation, modeling software, and 3D printers has lowered costs associated with PSCIs. However, requirements of time and technical expertise have prevented widespread utilization. Our objective was to create a fully automated software algorithm that is able to generate a virtual model (.STL) of a negative of an implant using CT imaging following DHC.

methodsA freeware algorithm (CranialRebuild) was constructed with the following capabilities: (1) after the upload of digital imaging and communications in medicine files, the normal side is analyzed in reference to the side of DHC, (2) Boolean subtraction is used to obtain a virtual image of the desired implant, and (3) a two-piece virtual model (.STL) of the PSCI mold is generated. In four cadaveric specimens, a standard DHC was performed. Post-DHC CT imaging was used to obtain a .STL of the negative of the implant, which was then printed using poly-lactic acid (PLA). Methylmethacrylate cement was used to generate a PSCI from the mold. The PSCIs were implanted into the index specimens; cosmesis was subjectively evaluated using a 5-point Likert scale.

resultsTwo specimens were graded as 4/5, indicating that minor post-processing modification was needed for optimal cosmesis. Two specimens were graded as 3/5, indicating that optimal cosmesis could be obtained following moderate post-processing modification.

conclusionsCranialRebuild can be used to create hermetically precise PSCIs at a fraction of the price of third-party vendors. Validation of this technology has significant implications for the accessibility of customized cranial implants worldwide.

Indexed as

Printing, Three-DimensionalSkullBone CementsHumansImaging, Three-DimensionalProstheses and ImplantsBone Cements3D printingCost-effectiveCranialRebuildCranioplastyPatient-specific cranial implants

Identifiers

PMID37351673
OpenAlexW4381715261

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.