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定制化多层 3D 打印植入物在脊柱肿瘤重建中的应用:单中心回顾性病例系列研究。

Customized Multilevel 3D Printing Implant for Reconstructing Spine Tumor: A Retrospective Case Series Study in a Single Center.

机构信息

Department of Musculoskeletal Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China.

Department of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

Orthop Surg. 2022 Sep;14(9):2016-2022. doi: 10.1111/os.13357. Epub 2022 Jul 27.

Abstract

OBJECTIVE

To investigate the clinical efficacy and safety of 3D printed artificial vertebral body for patients who underwent multilevel total en bloc spondylectomy (TES) and analyze whether it could reduce the incidence of implant subsidence.

METHODS

This is a retrospective study. From January 2017 to May 2018, eight consecutive cases with spine tumor undergoing multilevel TES were analyzed. All patients underwent X-ray and CT examinations to evaluate the stability of internal fixation during the postoperative follow-up. Demographic, surgical details, clinical data, and perioperative complications was collected. Visual analog scale, Frankel score, and spinal instability neoplastic score (SINS) classification were also recorded.

RESULTS

There were six cases of primary spinal tumor and two cases of metastatic spinal tumor. All patients achieved remarkable pain relief and improvement in neurological function. Five patients underwent operation through the posterior approach, one patient underwent operation through the anterior approach and the remaining two patients through a combined anterior and posterior approach. At the last follow-up period, X-rays showed that the 3D printed artificial vertebral body of all cases matched well, and the fixation was reliable. Hardware failure such as loosening, sinking, breaking, and displacement wasn't observed during the follow-up period.

CONCLUSION

3D printed customized artificial vertebral body can provide satisfying good clinical and radiological outcomes for patients who have undergone multilevel TES.

摘要

目的

研究多节段全脊椎整块切除术(TES)患者使用 3D 打印人工椎体的临床疗效和安全性,并分析其是否能降低植入物下沉的发生率。

方法

这是一项回顾性研究。2017 年 1 月至 2018 年 5 月,分析了 8 例连续接受多节段 TES 的脊柱肿瘤患者。所有患者术后均行 X 线和 CT 检查,以评估内固定的稳定性。收集患者的一般资料、手术细节、临床资料和围手术期并发症等信息。记录视觉模拟评分(VAS)、Frankel 评分和脊柱肿瘤不稳定评分(SINS)分类。

结果

原发性脊柱肿瘤 6 例,转移性脊柱肿瘤 2 例。所有患者均获得了显著的疼痛缓解和神经功能改善。5 例患者采用后路手术入路,1 例患者采用前路手术入路,2 例患者采用前后联合入路。末次随访时,X 线片显示所有患者的 3D 打印人工椎体匹配良好,固定可靠。随访期间未观察到硬件松动、下沉、断裂和移位等失效情况。

结论

3D 打印定制人工椎体可为接受多节段 TES 的患者提供满意的临床和影像学结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b222/9483039/fbc9a0707dcc/OS-14-2016-g002.jpg

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