Department of Orthopedics, Chinese PLA General Hospital, Beijing, China.
Medical School of Nankai University, Tianjin, China.
Spine (Phila Pa 1976). 2017 Nov 15;42(22):E1326-E1330. doi: 10.1097/BRS.0000000000002229.
MINI: A 3D printing technology is proposed for reconstructing multilevel cervical spine (C2-C4) after resection of metastatic papillary thyroid carcinoma. The personalized porous implant printed in Ti6AL4V provided excellent physicochemical properties and biological performance, including biocompatibility, osteogenic activity, and bone ingrowth effect.
A unique case report.
A three-dimensional (3D) printing technology is proposed for reconstructing multilevel cervical spine (C2-C4) after resection of metastatic papillary thyroid carcinoma in a middle-age female patient.
Papillary thyroid carcinoma is a malignant neoplasm with a relatively favorable prognosis. A metastatic lesion in multilevel cervical spine (C2-C4) destroys neurological functions and causes local instability. Radical excision of the metastasis and reconstruction of the cervical vertebrae sequence conforms with therapeutic principles, whereas the special-shaped multilevel upper-cervical spine requires personalized implants. 3D printing is an additive manufacturing technology that produces personalized products by accurately layering material under digital model control via a computer. Reporting of this recent technology for reconstructing multilevel cervical spine (C2-C4) is rare in the literature.
Anterior-posterior surgery was performed in one stage. Radical resection of the metastatic lesion (C2-C4) and thyroid gland, along with insertion of a personalized implant manufactured by 3D printing technology, were performed to rebuild the cervical spine sequences. The porous implant was printed in Ti6AL4V with perfect physicochemical properties and biological performance, such as biocompatibility and osteogenic activity. Finally, lateral mass screw fixation was performed via a posterior approach.
Patient neurological function gradually improved after the surgery. The patient received 11/17 on the Japanese Orthopedic Association scale and ambulated with a personalized skull-neck-thorax orthosis on postoperative day 11. She received radioiodine I therapy. The plane x-rays and computed tomography revealed no implant displacement or subsidence at the 12-month follow-up mark.
The presented case substantiates the use of 3D printing technology, which enables the personalization of products to solve unconventional problems in spinal surgery.
MINI：提出了一种 3D 打印技术，用于重建因转移性甲状腺乳头状癌切除术后的多节段颈椎（C2-C4）。个性化多孔植入物采用 Ti6AL4V 打印，具有出色的理化性能和生物性能，包括生物相容性、成骨活性和骨长入效果。
独特的病例报告。
提出一种 3D 打印技术，用于重建一名中年女性因转移性甲状腺乳头状癌切除术后的多节段颈椎（C2-C4）。
甲状腺乳头状癌是一种恶性肿瘤，预后相对较好。多节段颈椎（C2-C4）的转移瘤破坏神经功能并导致局部不稳定。对转移瘤进行根治性切除和颈椎序列重建符合治疗原则，而特殊形状的多节段颈椎需要个性化植入物。3D 打印是一种增材制造技术，通过数字模型控制下的精确分层材料，在计算机的控制下制造出个性化产品。文献中很少有关于使用这种新技术重建多节段颈椎（C2-C4）的报道。
一期行前后路手术。进行了根治性切除转移性病变（C2-C4）和甲状腺，同时插入 3D 打印技术制造的个性化植入物，重建颈椎序列。多孔植入物采用 Ti6AL4V 打印，具有完美的理化性能和生物性能，如生物相容性和成骨活性。最后通过后路行侧块螺钉固定。
患者术后神经功能逐渐改善。术后第 11 天，患者按日本矫形协会评分得 11/17 分，佩戴个性化头颈胸矫形器行走。患者接受放射性碘 I 治疗。X 线平片和 CT 显示，12 个月随访时无植入物移位或下沉。
该病例证实了 3D 打印技术的应用，该技术能够个性化产品，解决脊柱外科中的非常规问题。
5 级。
