“An implant in the neck” may be the only phrase someone remembers walking out of a spine consult. Finding out the device was built from that person’s own scans raises a fair question. How long did that take, and what happens if it doesn’t fit right? In July 2025, a surgical team at UC San Diego Health used a 3D-printed implant during an anterior neck fusion. The device was built from that one patient’s anatomy rather than pulled off a shelf.
Joseph Osorio, MD, the neurosurgeon who led the case, compares the idea to a fingerprint. Every spine looks a little different, the same way every fingerprint does. Planning a 3D-printed implant takes real time, since the design has to be approved and printed before the operation starts. A single case does not prove anything at scale, and larger studies still need to track healing and reoperation rates.
How a 3D-Printed Implant Starts as a Scan, Not a Shelf Part
During anterior cervical discectomy and fusion, a damaged disc comes out through an incision at the front of the neck. That step frees a pinched nerve or the spinal cord underneath it. A spacer then fills the space where the disc used to be. The goal is for the two vertebrae to grow into one solid piece.
For this device, that spacer started on a computer screen instead of a supply shelf. UC San Diego Health reported that the team captured detailed scans and ran AI-assisted planning before printing anything. Surgeons compared a planned cage against the bone shown on the scan, an example of what precision technology in neurosurgery looks like in practice. A device maker then printed the approved design in titanium.
Standard Cages Come in Preset Sizes for a Reason
Most fusion cages are pre-manufactured in a handful of heights and widths. Surgeons pick whichever size fits best once the disc is out. That works well for most necks. It works less well after old surgery, bone loss, or years of wear have left uneven bone that no preset size sits against cleanly.
A custom plan flips that order around. The shape comes from the bone on the scan first, and the cage gets built to match it. Design choices can set the height, the angle, and how much surface touches each vertebra.
Getting a Custom Implant Ready Takes Extra Steps
Scans have to reach the device maker before printing starts. Someone still has to approve the design before production begins. That sequence does not compress well under time pressure, which is why an urgent operation is a poor candidate for it. A surgery date usually gets built around the design and printing timeline instead of the other way around, and a delayed implant can mean a delayed operation.
A 3D-Printed Implant Is Still a Fusion Device
Once the custom cage is in place, bone has to grow solidly across that level. If fusion succeeds, the treated segment loses its motion for good. Two spine surgeons can reach different conclusions from the same scan. That difference is part of why patients sometimes ask how a neurosurgeon and an orthopedic spine surgeon compare, since training can shape that call.
Recovery carries the same lifting limits and follow-up imaging as any other cervical fusion. During recovery after ACDF surgery, those scans exist to check one thing. They confirm whether the bone is joining across the treated level. Before discharge, most patients can find out which scan comes next and roughly when.
One Surgery Answers a Narrow Question
What happened in July 2025 was a single case moving from scan to design to a printed cage. Surgeons placed the device through the front of the neck. UC San Diego Health called it the first fully custom anterior neck fusion of its kind. The health system was upfront that the report did not compare the device against a standard cage or include long-term follow-up.
A single case without a comparison group is a case report, not a clinical trial. Custom-printed implants had shown up in spine surgery before 2025, just not in this form. Earlier versions replaced entire vertebral bodies or served as plates fixed to the back of the neck.
The Evidence for a 3D-Printed Implant Is Still Thin
A 2020 review in Clinical Spine Surgery looked at 17 studies on custom 3D-printed spine implants. Those studies covered only 35 patients between them, and each one was a case report or a small case series rather than a controlled trial. Follow-up ranged from 3 to 36 months. In 11 of those cases, the implant sank more than 3 millimeters into the surrounding bone, and one patient needed a second operation.
Much of that earlier evidence came from tumor reconstruction and other complex cases. Results from those cases do not translate cleanly to a routine neck fusion.
When a Surgeon Might Bring Up a Custom Cage
Prior neck surgery, major bone loss, or a vertebra with atypical dimensions can all make a preset cage a poor fit. Those are the situations where a 3D-printed implant usually gets raised. It comes up as a response to a scan finding a preset size cannot accommodate, not as a default upgrade.
Custom printing adds cost and time that not every hospital offers. A second opinion is a reasonable place to ask a surgeon to point directly at the bone contour driving the recommendation. That same visit is also the place to ask which preset cage they would use if custom printing were not an option.
Five Questions Worth Bringing to a Surgical Visit
A pre-op visit is usually where a standard cage and a custom model end up side by side on the same screen. That side-by-side view is a natural moment to ask about the difference directly.
- Which part of my scan makes a preset cage a poor fit?
- What will the custom design change during surgery?
- How long will design approval and printing take before I can be scheduled?
- How will fusion and subsidence be checked afterward?
- Which preset cage would you use if the custom device were not available?
One more thing to raise: what happens if the bone looks different once the incision is open. Someone should be able to say in advance who makes that call. Patients can also ask which backup implant will already be in the room.
What Patients Ask About a 3D-Printed Implant
Is a custom cervical implant the same thing as an artificial disc?
No. An artificial disc is built to preserve motion at that level. A custom fusion cage does the opposite by design, staying in the disc space so the vertebrae can join into one piece. Anyone unsure which outcome they are getting can ask directly whether motion preservation is even part of the surgical goal.
Did artificial intelligence perform the surgery?
Not even close. A surgeon carried out every part of the operation by hand. AI-assisted software helped translate scan data into a design before the procedure started. A surgeon still had to review and approve that design before it went to print.
Will insurance cover a custom cervical implant?
Coverage comes down to the health plan and how the hospital codes and bills the device. That varies enough to raise directly before scheduling anything. A preset cage may carry a different cost estimate entirely, and that comparison is reasonable to request too.
What to Confirm Before a 3D-Printed Implant Gets Ordered
A surgeon should be able to point to the scan finding that justified a custom plan rather than a preset one. That reasoning belongs in the visit notes along with the planned print date. Before leaving that appointment, a patient should already know which follow-up scan is coming and roughly when.
Bringing the five questions above into that same visit turns a fast-moving decision into one with a paper trail. Both the patient and the surgical team can point back to those notes later, whether the surgery goes as planned or the bone tells a different story once the incision is open.
Sources
UC San Diego Health, World’s First Custom Anterior Cervical Spine Surgery
Clinical Spine Surgery, systematic review of custom 3D-printed spine implants
