European neurosurgery shifts 3D printing in-house as implants emerge

In a European neurosurgical department, the 3D printer is increasingly moving closer to the people who use its output. Between 2020 and 2025, the share of surveyed departments reporting neurosurgeons directly performing printing rose from zero to 20.68%; engineer involvement rose from 1.18% to 18.96%, while printing by research staff rose from zero to 12.06%. Departments naming an external company as their printing resource fell from 21.81% in 2020 to zero among 2025 respondents.

Researchers from University Medical Center Hamburg–Eppendorf and institutions of the German Armed Forces published the comparison in the International Journal of Bioprinting. It covers 172 completed questionnaires: 114 responses from 44 countries in 2020 and 58 responses from 19 countries in 2025. Sixteen participants completed both surveys, but the respondent groups were not identical, so the authors treat the findings as a trend over time, not proof that each individual hospital changed.

The infrastructure behind the shift is becoming more local. Most 2025 respondents reported that dedicated 3D-printing centers had been established after 2020, with centralized in-house laboratories the most common collaboration model. More than half reported better access to printing capacity since 2020. Single-case-only applications fell from 20% in 2020 to zero in 2025, a pattern the researchers connect with printing becoming part of recurring clinical workflows, even though routine deployment remained comparatively limited.

The most consequential change concerns what gets printed. Surgical planning and resident training remained established uses, while implant fabrication rose from zero respondents in 2020 to 27.58% in 2025. That moves the technology beyond models used for visualization and simulation toward parts that can play a direct role in treatment. The researchers therefore point to accuracy, biocompatibility, quality management and regulatory requirements as growing concerns; formal quality-assessment procedures, however, remained limited.

Concretely, more than half of 2025 respondents reported better access to 3D-printing capacity, while implant fabrication was reported by 27.58% of 2025 respondents. The survey does not yet establish effects on operative time, complication rates, patient outcomes or cost-effectiveness. Around 38% reported ongoing research, and the authors call for prospective studies and standardized measures before the clinical effect can be judged across institutions.