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新型3D打印模块化半骶骨植入物用于骶骨骨巨细胞瘤半骶骨切除术后的重建

Reconstruction after hemisacrectomy with a novel 3D-printed modular hemisacrum implant in sacral giant cell tumor of the bone.

作者信息

Lv Zhaorui, Li Jianmin, Yang Zhiping, Li Xin, Yang Qiang, Li Zhenfeng

机构信息

Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong, China.

Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.

出版信息

Front Bioeng Biotechnol. 2023 May 2;11:1155470. doi: 10.3389/fbioe.2023.1155470. eCollection 2023.

Abstract

There are a limited but increasing number of case reports and series describing the use of 3D-printed prostheses in bone tumor surgery. We describe a new approach to performing nerve-preserving hemisacrectomy in patients with sacral giant cell tumors with reconstruction using a novel 3D-printed patient-specific modular prosthesis. The series included four female and two male patients with a mean age of 34 years (range, 28-42 years). Surgical data, imaging assessments, tumor and functional status, implant status, and complications were retrospectively analyzed in six consecutive patients. In all cases, the tumor was removed by sagittal hemisacrectomy, and the prosthesis was successfully implanted. The mean follow-up time was 25 months (range, 15-32 months). All patients in this report achieved successful surgical outcomes and symptomatic relief without significant complications. Clinical and radiological follow-up showed good results in all cases. The mean MSTS score was 27.2 (range, 26-28). The average VAS was 1 (range, 0-2). No structural failures or deep infections were detected in this study at the time of follow-up. All patients had good neurological function. Two cases had superficial wound complications. Bone fusion was good with a mean fusion time of 3.5 months (range, 3-5 months). These cases describe the successful use of custom 3D-printed prostheses for reconstruction after sagittal nerve-sparing hemisacrectomy with excellent clinical outcomes, osseointegration, and durability.

摘要

描述骨肿瘤手术中使用3D打印假体的病例报告和系列研究数量有限但在不断增加。我们描述了一种新的方法,用于对骶骨巨细胞瘤患者进行保留神经的半骶骨切除术,并使用新型3D打印的个性化模块化假体进行重建。该系列包括4名女性和2名男性患者,平均年龄34岁(范围28 - 42岁)。对连续6例患者的手术数据、影像学评估、肿瘤及功能状态、植入物状态和并发症进行了回顾性分析。在所有病例中,通过矢状半骶骨切除术切除肿瘤,并成功植入假体。平均随访时间为25个月(范围15 - 32个月)。本报告中的所有患者均取得了成功的手术结果且症状缓解,无明显并发症。临床和影像学随访在所有病例中均显示出良好结果。平均MSTS评分为27.2(范围26 - 28)。平均VAS评分为1(范围0 - 2)。随访时本研究未检测到结构失败或深部感染。所有患者神经功能良好。2例出现浅表伤口并发症。骨融合良好,平均融合时间为3.5个月(范围3 - 5个月)。这些病例描述了定制3D打印假体在矢状位保留神经半骶骨切除术后重建中的成功应用,具有出色的临床效果、骨整合和耐久性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24be/10185765/24feb7b2114c/fbioe-11-1155470-g001.jpg

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