European Spine Journal

, Volume 25, Issue 7, pp 2239–2246 | Cite as

Surgical planning, manufacturing and implantation of an individualized cervical fusion titanium cage using patient-specific data

  • Uwe Spetzger
  • Miles Frasca
  • Stefan Alexander KönigEmail author
Ideas and Technical Innovations



Most cervical fusion cages imperfectly mimic the anatomy of the intervertebral disc space. The production of individualized cages might be the next step to further improve spinal implants due to their enhanced load-bearing surface.


To evaluate the planning, manufacturing, and implantation of an individualized cervical cage in co-operation with EIT and 3D Systems.


A digital 3D model of the patient’s cervical spine was rendered from the patients CT data. It was then possible to correct degenerative deformities by digitally repositioning the vertebrae and virtually resecting the osteophytes. The implantation of the cage can be simulated to check the accuracy of the fit. The cage is made of trabecular titanium and manufactured by Direct Metal Printing.


The pilot project for the implantation of the first individualized cervical cage ever, resulted in a highly accurate fit. During surgery, the cage self-located into the correct position after suspending distraction due to the implants unique end plate design. Furthermore, it was impossible to move the cage in any direction with the inserting instrument after suspending distraction for the same reason. Thus, it can be assumed that an individualized cervical implant provides excellent primary stability.


Preconditions for the manufacturing of individualized cervical fusion cages using specific patient data are given. The implantation is uncomplicated. The improved load-bearing surface will lower the rate of implant dislocation and subsidence. The production of individualized cages at a reasonable price has to be evaluated by spine surgeons and the industry.


Titanium cage Cervical spine Fusion Patient data Computer-aided design 3D modeling Manufacturing 


Compliance with ethical standards

Conflict of interest

The authors have no personal financial or institutional interest in any of the materials, or devices described in this article.

Supplementary material

Supplementary material 1 (MP4 342865 kb)

586_2016_4473_MOESM2_ESM.docx (12 kb)
Supplementary material 2 (DOCX 11 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Uwe Spetzger
    • 1
  • Miles Frasca
    • 2
  • Stefan Alexander König
    • 1
    Email author
  1. 1.Neurochirurgische Klinik, Klinikum KarlsruheKarlsruheGermany
  2. 2.3D Systems CorporationRock HillUSA

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