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全椎体整块切除术后3D打印个性化椎体植入物的生物力学和临床评估:两年随访结果

Biomechanical and clinical evaluation of 3D-printed personalized vertebral implants after total En-Bloc spondylectomy: two-year follow-up outcomes.

作者信息

Aleinikov Viktor G, Kerimbayev Talgat T, Kenzhegulov Yergen N, Zhamoldin Daniyar K, Tuigynov Zhandos M, Urunbayev Ermek A, Abishev Nurzhan B, Oshayev Meirzhan S, Baiskhanova Dinara M, Solodovnikov Makar P, Akshulakov Serik K, Kerimbayeva Diana

机构信息

Department of Spinal Surgery and Pathology of the Peripheral Nervous System, National Centre for Neurosurgery, Astana, Kazakhstan.

Laboratory of Molecular Gastroenterology and Tumor Biology, Institute for Experimental Cancer Research, Christian-Albrechts-University of Kiel, Kiel, Germany.

出版信息

3D Print Med. 2025 Aug 1;11(1):43. doi: 10.1186/s41205-025-00294-7.

Abstract

BACKGROUND

This prospective study evaluated the efficacy of 3D-printed personalized vertebral implants in restoring spinal stability following total en bloc spondylectomy (TES) for benign spinal tumors. Given the lack of specialized implants for post-resection reconstruction, this approach integrates customized 3D-printed implants to enhance the anatomical precision, biomechanical stability, and clinical outcomes.

METHODS

Four patients underwent TES using custom-designed 3D-printed vertebral implants. Key surgical parameters including operative time, intraoperative blood loss, pain reduction (VAS), and functional recovery (ODI) were assessed. Biomechanical testing was conducted to evaluate implant durability under high loads. Functional and neurological outcomes were monitored over a two-year follow-up period using clinical assessments and CT imaging.

RESULTS

Personalized 3D-printed implants demonstrated high mechanical stability with no structural deformation under load-bearing conditions. Postoperative VAS and ODI scores significantly improved, indicating substantial pain reduction and enhanced functional recovery. Neurological evaluations revealed that 75% of patients regained full motor and sensory functions. CT imaging confirmed stable implant positioning, with no signs of subsidence, fixation failure, or implant-related complications.

CONCLUSIONS

This study highlights the clinical feasibility and potential advantages of 3D-printed personalized vertebral implants for spinal reconstruction, including optimized surgical planning, reduced operative time, and minimal blood loss. Despite promising short-term outcomes, further large-scale, multicenter trials are required to establish long-term clinical efficacy and broader applicability in diverse patient populations.

摘要

背景

本前瞻性研究评估了3D打印个性化椎体植入物在良性脊柱肿瘤整块全脊椎切除术(TES)后恢复脊柱稳定性的疗效。鉴于缺乏用于切除后重建的专用植入物,该方法整合了定制的3D打印植入物,以提高解剖精度、生物力学稳定性和临床效果。

方法

4例患者接受了使用定制设计的3D打印椎体植入物的TES手术。评估了包括手术时间、术中出血量、疼痛减轻程度(视觉模拟评分法,VAS)和功能恢复情况(Oswestry功能障碍指数,ODI)等关键手术参数。进行了生物力学测试,以评估植入物在高负荷下的耐用性。在两年的随访期内,通过临床评估和CT成像监测功能和神经学结果。

结果

个性化3D打印植入物在承重条件下显示出高机械稳定性,无结构变形。术后VAS和ODI评分显著改善,表明疼痛大幅减轻,功能恢复增强。神经学评估显示,75%的患者恢复了完全的运动和感觉功能。CT成像证实植入物位置稳定,无下沉、固定失败或与植入物相关并发症的迹象。

结论

本研究强调了3D打印个性化椎体植入物用于脊柱重建的临床可行性和潜在优势,包括优化手术规划、缩短手术时间和减少出血量。尽管短期结果令人鼓舞,但仍需要进一步的大规模、多中心试验来确定其长期临床疗效以及在不同患者群体中的更广泛适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eefa/12315295/703d5a62527a/41205_2025_294_Fig1_HTML.jpg

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