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Reconstruction of the pelvic ring after total en bloc sacrectomy using a 3D-printed sacral endoprosthesis with re-establishment of spinopelvic stability: a retrospective comparative study.
Bone Joint J. 2019 07; 101-B(7):880-888.BJ

Abstract

AIMS

The aim of this study was to describe the use of 3D-printed sacral endoprostheses to reconstruct the pelvic ring and re-establish spinopelvic stability after total en bloc sacrectomy (TES) and to review its outcome.

PATIENTS AND METHODS

We retrospectively reviewed 32 patients who underwent TES in our hospital between January 2015 and December 2017. We divided the patients into three groups on the basis of the method of reconstruction: an endoprosthesis group (n = 10); a combined reconstruction group (n = 14), who underwent non-endoprosthetic combined reconstruction, including anterior spinal column fixation; and a spinopelvic fixation (SPF) group (n = 8), who underwent only SPF. Spinopelvic stability, implant survival (IS), intraoperative haemorrhage rate, and perioperative complication rate in the endoprosthesis group were documented and compared with those of other two groups.

RESULTS

The mean overall follow-up was 22.1 months (9 to 44). In the endoprosthesis group, the mean intraoperative hemorrhage was 3530 ml (1600 to 8100). Perioperative complications occurred in two patients; both had problems with wound healing. After a mean follow-up of 17.7 months (12 to 38), 9/10 patients could walk without aids and 8/10 patients were not using analgesics. Imaging evidence of implant failure was found in three patients, all of whom had breakage of screws and/or rods. Only one of these, who had a local recurrence, underwent re-operation, at which solid bone-endoprosthetic osseointegration was found. The mean IS using re-operation as the endpoint was 32.5 months (95% confidence interval 23.2 to 41.8). Compared with the other two groups, the endoprosthesis group had significantly better spinopelvic stability and IS with no greater intraoperative haemorrhage or perioperative complications.

CONCLUSION

The use of 3D-printed endoprostheses for reconstruction after TES provides reliable spinopelvic stability and IS by facilitating osseointegration at the bone-implant interfaces, with acceptable levels of haemorrhage and complications. Cite this article: Bone Joint J 2019;101-B:880-888.

Authors+Show Affiliations

Musculoskeletal Tumour Centre, Beijing Key Laboratory for Musculoskeletal Tumours, Peking University People's Hospital, Beijing, China.Musculoskeletal Tumour Centre, Beijing Key Laboratory for Musculoskeletal Tumours, Peking University People's Hospital, Beijing, China.Musculoskeletal Tumour Centre, Beijing Key Laboratory for Musculoskeletal Tumours, Peking University People's Hospital, Beijing, China.Musculoskeletal Tumour Centre, Beijing Key Laboratory for Musculoskeletal Tumours, Peking University People's Hospital, Beijing, China.Musculoskeletal Tumour Centre, Beijing Key Laboratory for Musculoskeletal Tumours, Peking University People's Hospital, Beijing, China.Musculoskeletal Tumour Centre, Beijing Key Laboratory for Musculoskeletal Tumours, Peking University People's Hospital, Beijing, China.Musculoskeletal Tumour Centre, Beijing Key Laboratory for Musculoskeletal Tumours, Peking University People's Hospital, Beijing, China.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

31256665

Citation

Wei, R, et al. "Reconstruction of the Pelvic Ring After Total En Bloc Sacrectomy Using a 3D-printed Sacral Endoprosthesis With Re-establishment of Spinopelvic Stability: a Retrospective Comparative Study." The Bone & Joint Journal, vol. 101-B, no. 7, 2019, pp. 880-888.
Wei R, Guo W, Yang R, et al. Reconstruction of the pelvic ring after total en bloc sacrectomy using a 3D-printed sacral endoprosthesis with re-establishment of spinopelvic stability: a retrospective comparative study. Bone Joint J. 2019;101-B(7):880-888.
Wei, R., Guo, W., Yang, R., Tang, X., Yang, Y., Ji, T., & Liang, H. (2019). Reconstruction of the pelvic ring after total en bloc sacrectomy using a 3D-printed sacral endoprosthesis with re-establishment of spinopelvic stability: a retrospective comparative study. The Bone & Joint Journal, 101-B(7), 880-888. https://doi.org/10.1302/0301-620X.101B7.BJJ-2018-1010.R2
Wei R, et al. Reconstruction of the Pelvic Ring After Total En Bloc Sacrectomy Using a 3D-printed Sacral Endoprosthesis With Re-establishment of Spinopelvic Stability: a Retrospective Comparative Study. Bone Joint J. 2019;101-B(7):880-888. PubMed PMID: 31256665.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reconstruction of the pelvic ring after total en bloc sacrectomy using a 3D-printed sacral endoprosthesis with re-establishment of spinopelvic stability: a retrospective comparative study. AU - Wei,R, AU - Guo,W, AU - Yang,R, AU - Tang,X, AU - Yang,Y, AU - Ji,T, AU - Liang,H, PY - 2019/7/2/entrez PY - 2019/7/2/pubmed PY - 2019/7/10/medline KW - 3D printed endoprosthesis KW - En bloc KW - Spinopelvic stability KW - Total sacrectomy SP - 880 EP - 888 JF - The bone & joint journal JO - Bone Joint J VL - 101-B IS - 7 N2 - AIMS: The aim of this study was to describe the use of 3D-printed sacral endoprostheses to reconstruct the pelvic ring and re-establish spinopelvic stability after total en bloc sacrectomy (TES) and to review its outcome. PATIENTS AND METHODS: We retrospectively reviewed 32 patients who underwent TES in our hospital between January 2015 and December 2017. We divided the patients into three groups on the basis of the method of reconstruction: an endoprosthesis group (n = 10); a combined reconstruction group (n = 14), who underwent non-endoprosthetic combined reconstruction, including anterior spinal column fixation; and a spinopelvic fixation (SPF) group (n = 8), who underwent only SPF. Spinopelvic stability, implant survival (IS), intraoperative haemorrhage rate, and perioperative complication rate in the endoprosthesis group were documented and compared with those of other two groups. RESULTS: The mean overall follow-up was 22.1 months (9 to 44). In the endoprosthesis group, the mean intraoperative hemorrhage was 3530 ml (1600 to 8100). Perioperative complications occurred in two patients; both had problems with wound healing. After a mean follow-up of 17.7 months (12 to 38), 9/10 patients could walk without aids and 8/10 patients were not using analgesics. Imaging evidence of implant failure was found in three patients, all of whom had breakage of screws and/or rods. Only one of these, who had a local recurrence, underwent re-operation, at which solid bone-endoprosthetic osseointegration was found. The mean IS using re-operation as the endpoint was 32.5 months (95% confidence interval 23.2 to 41.8). Compared with the other two groups, the endoprosthesis group had significantly better spinopelvic stability and IS with no greater intraoperative haemorrhage or perioperative complications. CONCLUSION: The use of 3D-printed endoprostheses for reconstruction after TES provides reliable spinopelvic stability and IS by facilitating osseointegration at the bone-implant interfaces, with acceptable levels of haemorrhage and complications. Cite this article: Bone Joint J 2019;101-B:880-888. SN - 2049-4408 UR - https://www.unboundmedicine.com/medline/citation/31256665/Reconstruction_of_the_pelvic_ring_after_total_en_bloc_sacrectomy_using_a_3D_printed_sacral_endoprosthesis_with_re_establishment_of_spinopelvic_stability:_a_retrospective_comparative_study_ L2 - https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.101B7.BJJ-2018-1010.R2?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -