Wen Jie Choy1, Ralph J Mobbs2, Ben Wilcox1, Steven Phan3, Kevin Phan4, Chester E Sutterlin5. 1. Faculty of Medicine, University of New South Wales, Sydney, Australia. 2. Faculty of Medicine, University of New South Wales, Sydney, Australia; Neuro Spine Surgery Research Group (NSURG), Sydney, Australia; Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia. Electronic address: r.mobbs@unsw.edu.au. 3. Neuro Spine Surgery Research Group (NSURG), Sydney, Australia; Faculty of Medicine, University of Sydney, Sydney, Australia. 4. Faculty of Medicine, University of New South Wales, Sydney, Australia; Neuro Spine Surgery Research Group (NSURG), Sydney, Australia; Faculty of Medicine, University of Sydney, Sydney, Australia; Spinal Health International Inc., Longboat Key, Florida, USA. 5. Department of Neurosurgery, University of Florida, Gainesville, Florida, USA; ProCRO Pty Ltd, Pyrmont, New South Wales, Australia; Spinal Health International Inc., Longboat Key, Florida, USA.
Abstract
BACKGROUND: Neurosurgery and spine surgery have the potential to benefit from the use of 3-dimensional printing (3DP) technology due to complex anatomic considerations and the delicate nature of surrounding structures. We report a procedure that uses a 3D-printed titanium T9 vertebral body implant post T9 vertebrectomy for a primary bone tumor. CASE DESCRIPTION: A 14-year-old female presented with progressive kyphoscoliosis and a pathologic fracture of the T9 vertebra with sagittal and coronal deformity due to a destructive primary bone tumor. Surgical resection and reconstruction was performed in combination with a 3D-printed, patient-specific implant. Custom design features included porous titanium end plates, corrective angulation of the implant to restore sagittal balance, and pedicle screw holes in the 3D implant to assist with insertion of the device. In addition, attachment of the anterior column construct to the posterior pedicle screw construct was possible due to the customized features of the patient-specific implant. CONCLUSIONS: An advantage of 3DP is the ability to manufacture patient-specific implants, as in the current case example. Additionally, the use of 3DP has been able to reduce operative time significantly. Surgical procedures can be preplanned using 3DP patient-specific models. Surgeons can train before performing complex procedures, which enhances their presurgical planning in order to maximize patient outcomes. When considering implants and prostheses, the use of 3DP allows a superior anatomic fit for the patient, with the potential to improve restoration of anatomy.
BACKGROUND: Neurosurgery and spine surgery have the potential to benefit from the use of 3-dimensional printing (3DP) technology due to complex anatomic considerations and the delicate nature of surrounding structures. We report a procedure that uses a 3D-printed titanium T9 vertebral body implant post T9 vertebrectomy for a primary bone tumor. CASE DESCRIPTION: A 14-year-old female presented with progressive kyphoscoliosis and a pathologic fracture of the T9 vertebra with sagittal and coronal deformity due to a destructive primary bone tumor. Surgical resection and reconstruction was performed in combination with a 3D-printed, patient-specific implant. Custom design features included porous titanium end plates, corrective angulation of the implant to restore sagittal balance, and pedicle screw holes in the 3D implant to assist with insertion of the device. In addition, attachment of the anterior column construct to the posterior pedicle screw construct was possible due to the customized features of the patient-specific implant. CONCLUSIONS: An advantage of 3DP is the ability to manufacture patient-specific implants, as in the current case example. Additionally, the use of 3DP has been able to reduce operative time significantly. Surgical procedures can be preplanned using 3DP patient-specific models. Surgeons can train before performing complex procedures, which enhances their presurgical planning in order to maximize patient outcomes. When considering implants and prostheses, the use of 3DP allows a superior anatomic fit for the patient, with the potential to improve restoration of anatomy.
Authors: Jackson K S Kwok; Rainbow W H Lau; Ze-Rui Zhao; Peter S Y Yu; Jacky Y K Ho; Simon C Y Chow; Innes Y P Wan; Calvin S H Ng Journal: J Thorac Dis Date: 2018-04 Impact factor: 2.895