Tags

Type your tag names separated by a space and hit enter

One-step reconstruction with a 3D-printed, custom-made prosthesis after total en bloc sacrectomy: a technical note.
Eur Spine J. 2017 07; 26(7):1902-1909.ES

Abstract

BACKGROUND

Surgeries for primary malignancies involving upper sacrum require total en bloc sacrectomy followed by complex mechanical reconstruction, which might be simplified by application of the three-dimensional (3D) printing technique.

PURPOSES

To describe the design of a 3D-printed custom-made prosthesis for reconstruction after total en bloc sacrectomy, the surgical technique, and the clinical and functional outcome of a patient.

METHODS

A 62-year-old patient with recurrent sacral chordoma was admitted in our center. One-stage total en bloc sacrectomy through posterior approach was planned, and a 3D-printed sacral prosthesis was prepared for reconstruction according to the anticipated osteotomic planes.

RESULTS

The patient received one-stage total en bloc sacrectomy through posterior approach followed by reconstruction with the 3D-printed sacral prosthesis. The whole procedure took 5 h, and intra-operative blood loss was 3400 ml. The patient recovered uneventfully and started ambulation at 3 weeks after surgery. An asymptomatic instrument failure was found radiographically at 8-month follow-up. At 1 year after surgery, the patient was disease free and could walk over short distance with crutches without pain or any mechanical instability.

CONCLUSIONS

The advantages of our reconstruction method included: (1) the prosthesis provided an optimal reconstruction of lumbosacral and pelvic ring by integrating spinal pelvic fixation, posterior pelvic ring fixation, and anterior spinal column fixation in one step and (2) its porous surface could induce bone ingrowth and might enhance stability. Although there was an instrumental failure, we considered that it could be one reconstructive option. More research is warranted focusing on the modification of locations, diameters, and quantity of screws and biomechanical characteristics. The long-term functional and bone in-growth outcome will be followed to validate the use of the prosthesis.

Authors+Show Affiliations

Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China. bonetumor@163.com.Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

27844229

Citation

Wei, Ran, et al. "One-step Reconstruction With a 3D-printed, Custom-made Prosthesis After Total En Bloc Sacrectomy: a Technical Note." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 26, no. 7, 2017, pp. 1902-1909.
Wei R, Guo W, Ji T, et al. One-step reconstruction with a 3D-printed, custom-made prosthesis after total en bloc sacrectomy: a technical note. Eur Spine J. 2017;26(7):1902-1909.
Wei, R., Guo, W., Ji, T., Zhang, Y., & Liang, H. (2017). One-step reconstruction with a 3D-printed, custom-made prosthesis after total en bloc sacrectomy: a technical note. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 26(7), 1902-1909. https://doi.org/10.1007/s00586-016-4871-z
Wei R, et al. One-step Reconstruction With a 3D-printed, Custom-made Prosthesis After Total En Bloc Sacrectomy: a Technical Note. Eur Spine J. 2017;26(7):1902-1909. PubMed PMID: 27844229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - One-step reconstruction with a 3D-printed, custom-made prosthesis after total en bloc sacrectomy: a technical note. AU - Wei,Ran, AU - Guo,Wei, AU - Ji,Tao, AU - Zhang,Yidan, AU - Liang,Haijie, Y1 - 2016/11/14/ PY - 2016/08/07/received PY - 2016/11/08/accepted PY - 2016/10/12/revised PY - 2016/11/16/pubmed PY - 2018/3/15/medline PY - 2016/11/16/entrez KW - 3D printing KW - Chordoma KW - Oncology KW - Prosthesis KW - Reconstruction KW - Total en bloc sacrectomy SP - 1902 EP - 1909 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 26 IS - 7 N2 - BACKGROUND: Surgeries for primary malignancies involving upper sacrum require total en bloc sacrectomy followed by complex mechanical reconstruction, which might be simplified by application of the three-dimensional (3D) printing technique. PURPOSES: To describe the design of a 3D-printed custom-made prosthesis for reconstruction after total en bloc sacrectomy, the surgical technique, and the clinical and functional outcome of a patient. METHODS: A 62-year-old patient with recurrent sacral chordoma was admitted in our center. One-stage total en bloc sacrectomy through posterior approach was planned, and a 3D-printed sacral prosthesis was prepared for reconstruction according to the anticipated osteotomic planes. RESULTS: The patient received one-stage total en bloc sacrectomy through posterior approach followed by reconstruction with the 3D-printed sacral prosthesis. The whole procedure took 5 h, and intra-operative blood loss was 3400 ml. The patient recovered uneventfully and started ambulation at 3 weeks after surgery. An asymptomatic instrument failure was found radiographically at 8-month follow-up. At 1 year after surgery, the patient was disease free and could walk over short distance with crutches without pain or any mechanical instability. CONCLUSIONS: The advantages of our reconstruction method included: (1) the prosthesis provided an optimal reconstruction of lumbosacral and pelvic ring by integrating spinal pelvic fixation, posterior pelvic ring fixation, and anterior spinal column fixation in one step and (2) its porous surface could induce bone ingrowth and might enhance stability. Although there was an instrumental failure, we considered that it could be one reconstructive option. More research is warranted focusing on the modification of locations, diameters, and quantity of screws and biomechanical characteristics. The long-term functional and bone in-growth outcome will be followed to validate the use of the prosthesis. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/27844229/One_step_reconstruction_with_a_3D_printed_custom_made_prosthesis_after_total_en_bloc_sacrectomy:_a_technical_note_ L2 - https://doi.org/10.1007/s00586-016-4871-z DB - PRIME DP - Unbound Medicine ER -