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3D 打印人工椎体在全脊椎整块切除术治疗脊柱肿瘤后脊柱重建中的早期临床疗效。

Early clinical efficacy of 3D-printed artificial vertebral body in spinal reconstruction after total en bloc spondylectomy for spinal tumors.

机构信息

Department of Orthopaedics, Affiliated Hospital of Hebei University, No.212, Yuhua Road, Baoding City, Hebei, 071000, China.

Department of Surgery, Affiliated Hospital of Hebei University, Hebei, China.

出版信息

BMC Musculoskelet Disord. 2024 Nov 19;25(1):926. doi: 10.1186/s12891-024-08069-7.

Abstract

BACKGROUND

Total en bloc spondylectomy (TES) is a recognized surgical approach for managing spinal tumors. With advancements in three-dimensional (3D) printing technology, the use of 3D-printed prosthetics for vertebral reconstruction post-tumor resection has gained traction. However, research on the clinical implications of these prosthetics remains limited.

METHODS

This retrospective study evaluated patients who underwent TES for primary and metastatic thoracolumbar tumors at the Department of Spinal Surgery, Tianjin Hospital, between October 2017 and September 2020. These patients received anterior reconstruction with 3D-printed artificial vertebral bodies.

RESULTS

14 patients completed the surgery, with intraoperative blood loss ranging from 1,400 to 4,200 ml (mean 2,767 ± 790 ml) and operative duration between 240 and 520 min (mean 382 ± 75.9 min). The follow-up period extended from 7 to 43 months, with an average of 19.9 ± 9.5 months. Standardized prefabricated prosthetics were utilized in nine patients, while five received customized prosthetics. Throughout the follow-up, there were no reports of posterior connecting rod, 3D-printed prosthetic, or pedicle screw failures. Notably, one patient presented with significant prosthetic subsidence resulting in screw loosening, and three cases of prosthetic subsidence were observed.

CONCLUSION

The incorporation of 3D-printed prosthetics in TES procedures yielded favorable clinical outcomes. Further research is warranted to optimize these prosthetics for enhanced postoperative stability and patient-specific applications.

摘要

背景

全脊椎整块切除术(TES)是一种被认可的治疗脊柱肿瘤的手术方法。随着三维(3D)打印技术的进步,使用 3D 打印假体进行肿瘤切除后的椎体重建已经引起了关注。然而,关于这些假体的临床意义的研究仍然有限。

方法

本回顾性研究评估了 2017 年 10 月至 2020 年 9 月期间在天津医院脊柱外科接受 TES 治疗的原发性和转移性胸腰椎肿瘤患者。这些患者接受了 3D 打印人工椎体的前路重建。

结果

14 例患者完成了手术,术中出血量为 1400 至 4200ml(平均 2767±790ml),手术时间为 240 至 520min(平均 382±75.9min)。随访时间为 7 至 43 个月,平均 19.9±9.5 个月。9 例患者使用了标准化预制假体,5 例患者使用了定制假体。在整个随访期间,没有报告出现后连接杆、3D 打印假体或椎弓根螺钉失败的情况。值得注意的是,有 1 例患者出现明显假体下沉导致螺钉松动,3 例患者出现假体下沉。

结论

在 TES 手术中加入 3D 打印假体可获得良好的临床效果。需要进一步研究来优化这些假体,以提高术后稳定性和满足患者特定需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c585/11575014/0594f4ab4063/12891_2024_8069_Fig1_HTML.jpg

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