Department of Spine, Sichuan Science City Hospital, Mianyang, Sichuan Province, China.
J Orthop Surg Res. 2023 Aug 29;18(1):638. doi: 10.1186/s13018-023-04135-3.
Nerve compression symptoms and spinal instability, resulting from spinal metastases, significantly impact the quality of life for patients. A 3D-printed vertebral body is considered an effective approach to reconstruct bone defects following en bloc resection of spinal tumors. The advantage of this method lies in its customized shape and innermost porous structure, which promotes bone ingrowth and leads to reduced postoperative complications.
The purpose of this study is to assess the effectiveness of 3D-printed auto-stable artificial vertebrae in the en bloc resection and reconstruction of thoracolumbar metastases.
This study included patients who underwent en bloc resection of thoracolumbar metastases based on the Weinstein-Boriani-Biagini surgical staging system, between January 2019 and April 2021. The patients were divided into two groups: the observation group, which was reconstructed using 3D-printed auto-stable vertebral bodies, and the control group, treated with titanium cages and allograft bone. Evaluation criteria for the patients included assessment of implant subsidence, instrumentation-related complications, VAS score, and Frankel grading of spinal cord injury.
The median follow-up period was 21.8 months (range 12-38 months). Among the patients, 10 received a customized 3D-printed artificial vertebral body, while the remaining 10 received a titanium cage. The observation group showed significantly lower operation time, intraoperative blood loss, and postoperative drainage compared to the control group (P < 0.05). At the final follow-up, the average implant subsidence was 1.8 ± 2.1 mm for the observation group and 5.2 ± 5.1 mm for the control group (P < 0.05). The visual analog scale (VAS) scores were not statistically different between the two groups at preoperative, 24 h, 3 months, and 1 year after the operation (P < 0.05). There were no statistically significant differences in the improvements of spinal cord functions between the two groups.
The utilization of a 3D-printed auto-stable artificial vertebra for reconstruction following en bloc resection of thoracolumbar metastases appears to be a viable and dependable choice. The low occurrence of prosthesis subsidence with 3D-printed prostheses can offer immediate and robust stability.
脊柱转移导致的神经压迫症状和脊柱不稳，极大地影响了患者的生活质量。3D 打印椎体被认为是一种有效方法，可在整块切除脊柱肿瘤后重建骨缺损。该方法的优势在于其定制的形状和内部多孔结构，促进了骨长入，减少了术后并发症。
本研究旨在评估 3D 打印自稳人工椎体在胸腰椎转移整块切除和重建中的有效性。
本研究纳入了 2019 年 1 月至 2021 年 4 月期间基于 Weinstein-Boriani-Biagini 外科分期系统行胸腰椎转移整块切除术的患者。患者分为两组：观察组采用 3D 打印自稳人工椎体重建，对照组采用钛笼和同种异体骨重建。评估标准包括植入物下沉、器械相关并发症、视觉模拟评分（VAS）和脊髓损伤的 Frankel 分级。
中位随访时间为 21.8 个月（12-38 个月）。10 例患者接受了定制的 3D 打印人工椎体，10 例患者接受了钛笼。观察组的手术时间、术中出血量和术后引流量明显低于对照组（P < 0.05）。末次随访时，观察组平均植入物下沉 1.8 ± 2.1mm，对照组为 5.2 ± 5.1mm（P < 0.05）。两组术前、术后 24h、3 个月和 1 年 VAS 评分差异均无统计学意义（P < 0.05）。两组脊髓功能改善差异无统计学意义。
整块切除胸腰椎转移后，3D 打印自稳人工椎体重建是一种可行且可靠的选择。3D 打印假体的假体下沉发生率低，可提供即刻和坚固的稳定性。
