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通过3D打印制作的个性化多孔钽植入物:复杂颈胸段脊柱融合的新视野

Personalized porous tantalum implants crafted via 3D printing: new horizons in complex cervical-thoracic spinal fusion.

作者信息

Chen Chang, Fan Huaquan, Chen Ge, Li Zhong, Wang Puquan, Wang Fuyou

机构信息

Department of Traditional Chinese Medicine Rehabilitation, Jiangbei Branch of The First Hospital Affiliated to Army Medical University (Third Military Medical University), Chongqing, China.

Center for Joint Surgery, The First Hospital Affiliated to Army Medical University, Chongqing, China.

出版信息

Front Bioeng Biotechnol. 2025 Aug 21;13:1625650. doi: 10.3389/fbioe.2025.1625650. eCollection 2025.

Abstract

BACKGROUND

Complex interbody fusion remains challenging, while traditional surgical instruments are not suitable for complex spinal deformities. Porous tantalum (Ta) has excellent osteogenic properties, but there is currently a lack of research on its application in cervical thoracic interbody fusion.

OBJECTIVE

To introduce the application of selective electron beam melting (SEBM) 3D printing technology in customized porous Ta vertebral fusion implants and evaluate its mid-term clinical efficacy in complex cervical thoracic fusion surgery. Method: Porous Ta implants were manufactured using SEBM technology. The mechanical properties were optimized and characterized. Three patients who underwent complex cervical and thoracic fusion surgery were prospectively recruited. 3D printing technology is used for preoperative planning and customized implant design. Surgical techniques and postoperative management follow standard procedures, with regular follow-up including clinical and imaging evaluations.

RESULT

Porous Ta implants have satisfactory pore structure and surface characteristics, with mechanical properties. All three surgeries were successful. The operation time is 188-525 min (average 387.7 min), the intraoperative blood loss is 300-1,000 mL (average 695 mL), and the hospitalization time is 21-36 days (average 30.0 days). After an average follow-up of 24.3 months, the patient's pain symptoms improved significantly and no serious complications occurred.

CONCLUSION

The use of 3D printed personalized porous tantalum implants in complex spinal fusion procedures is feasible and has shown significant benefits. Future research should focus on validating these results through larger cohorts and long-term follow-up to explore the broader application prospects.

摘要

背景

复杂的椎间融合仍然具有挑战性,而传统手术器械并不适用于复杂的脊柱畸形。多孔钽具有优异的成骨特性,但目前缺乏其在颈胸椎间融合中应用的研究。

目的

介绍选择性电子束熔化(SEBM)3D打印技术在定制多孔钽椎间融合植入物中的应用,并评估其在复杂颈胸融合手术中的中期临床疗效。方法:采用SEBM技术制造多孔钽植入物。对其力学性能进行优化和表征。前瞻性招募3例行复杂颈胸融合手术的患者。使用3D打印技术进行术前规划和定制植入物设计。手术技术和术后管理遵循标准程序,定期随访,包括临床和影像学评估。

结果

多孔钽植入物具有令人满意的孔隙结构和表面特性以及力学性能。3例手术均成功。手术时间为188 - 525分钟(平均387.7分钟),术中出血量为300 - 1000毫升(平均695毫升),住院时间为21 - 36天(平均30.0天)。平均随访24.3个月后,患者疼痛症状明显改善,未发生严重并发症。

结论

在复杂脊柱融合手术中使用3D打印个性化多孔钽植入物是可行的,并已显示出显著益处。未来的研究应集中于通过更大规模的队列和长期随访来验证这些结果,以探索更广泛的应用前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ad6/12408612/7995c63a7173/fbioe-13-1625650-g001.jpg

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