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Upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2
BACKGROUND: Reconstruction following resection of the primary tumors of the upper cervical spine is challenging, and conventional internal implants develop complications in this region. 3D printing, also known as additive manufacturing, can produce patient-specific porous implants in a particular sh...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186708/ https://www.ncbi.nlm.nih.gov/pubmed/32355776 http://dx.doi.org/10.21037/atm.2020.03.32 |
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author | Wei, Feng Li, Zhehuang Liu, Zhongjun Liu, Xiaoguang Jiang, Liang Yu, Miao Xu, Nanfang Wu, Fengliang Dang, Lei Zhou, Hua Li, Zihe Cai, Hong |
author_facet | Wei, Feng Li, Zhehuang Liu, Zhongjun Liu, Xiaoguang Jiang, Liang Yu, Miao Xu, Nanfang Wu, Fengliang Dang, Lei Zhou, Hua Li, Zihe Cai, Hong |
author_sort | Wei, Feng |
collection | PubMed |
description | BACKGROUND: Reconstruction following resection of the primary tumors of the upper cervical spine is challenging, and conventional internal implants develop complications in this region. 3D printing, also known as additive manufacturing, can produce patient-specific porous implants in a particular shape for bone defect reconstruction. This study aimed to describe the clinical outcomes of upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2. METHODS: Patients with primary tumors involving C2 who were treated in our institution between July 2014 and November 2018 were enrolled. A two-stage intralesional spondylectomy was performed using the posterior-anterior approach. Anterior reconstruction was accomplished using a customized 3D-printed vertebral body, which was fabricated by successive layering of melted titanium alloy powder using electron beam melting. No bone graft was used. RESULTS: Nine patients (2 males and 7 females) were included in the study with a mean age of 31.4 years (12 to 59 years). Seven patients demonstrated tumors located in C2 and 2 showed involvement of C2 and C3. During a mean follow-up of 28.6 months (range, 12–42 months), 1 patient died of systemic metastasis and 1 had local tumor recurrence, the other 7 patients were alive and functional in their daily living until the last follow-up without evidence of disease. The 3D-printed vertebral bodies were all stable with no sign of displacement or subsidence, evidence of implant osseointegration was observed on the imaging studies. For the posterior instrumentation systems, no screw loosening or rod breakage was found. CONCLUSIONS: Spinal reconstruction in the upper cervical region using customized 3D-printed vertebral body is reliable. The tailored shape matching with the contact surfaces and the porous structure conductive to osseointegration provide both short- and long-term stability to the implant. |
format | Online Article Text |
id | pubmed-7186708 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-71867082020-04-30 Upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2 Wei, Feng Li, Zhehuang Liu, Zhongjun Liu, Xiaoguang Jiang, Liang Yu, Miao Xu, Nanfang Wu, Fengliang Dang, Lei Zhou, Hua Li, Zihe Cai, Hong Ann Transl Med Original Article BACKGROUND: Reconstruction following resection of the primary tumors of the upper cervical spine is challenging, and conventional internal implants develop complications in this region. 3D printing, also known as additive manufacturing, can produce patient-specific porous implants in a particular shape for bone defect reconstruction. This study aimed to describe the clinical outcomes of upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2. METHODS: Patients with primary tumors involving C2 who were treated in our institution between July 2014 and November 2018 were enrolled. A two-stage intralesional spondylectomy was performed using the posterior-anterior approach. Anterior reconstruction was accomplished using a customized 3D-printed vertebral body, which was fabricated by successive layering of melted titanium alloy powder using electron beam melting. No bone graft was used. RESULTS: Nine patients (2 males and 7 females) were included in the study with a mean age of 31.4 years (12 to 59 years). Seven patients demonstrated tumors located in C2 and 2 showed involvement of C2 and C3. During a mean follow-up of 28.6 months (range, 12–42 months), 1 patient died of systemic metastasis and 1 had local tumor recurrence, the other 7 patients were alive and functional in their daily living until the last follow-up without evidence of disease. The 3D-printed vertebral bodies were all stable with no sign of displacement or subsidence, evidence of implant osseointegration was observed on the imaging studies. For the posterior instrumentation systems, no screw loosening or rod breakage was found. CONCLUSIONS: Spinal reconstruction in the upper cervical region using customized 3D-printed vertebral body is reliable. The tailored shape matching with the contact surfaces and the porous structure conductive to osseointegration provide both short- and long-term stability to the implant. AME Publishing Company 2020-03 /pmc/articles/PMC7186708/ /pubmed/32355776 http://dx.doi.org/10.21037/atm.2020.03.32 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Wei, Feng Li, Zhehuang Liu, Zhongjun Liu, Xiaoguang Jiang, Liang Yu, Miao Xu, Nanfang Wu, Fengliang Dang, Lei Zhou, Hua Li, Zihe Cai, Hong Upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2 |
title | Upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2 |
title_full | Upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2 |
title_fullStr | Upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2 |
title_full_unstemmed | Upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2 |
title_short | Upper cervical spine reconstruction using customized 3D-printed vertebral body in 9 patients with primary tumors involving C2 |
title_sort | upper cervical spine reconstruction using customized 3d-printed vertebral body in 9 patients with primary tumors involving c2 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186708/ https://www.ncbi.nlm.nih.gov/pubmed/32355776 http://dx.doi.org/10.21037/atm.2020.03.32 |
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