Shaohui He1, Xinghai Yang1, Jian Yang1, Chen Ye1, Weibo Liu1,2, Haifeng Wei1, Jianru Xiao1. 1. Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China. 2. Department of Spine Surgery, Central Hospital of Qingdao, Shandong Province, China.
Abstract
BACKGROUND: Radical resection is the first-line option in managing cervical primary chondrosarcoma. Favorable anterior reconstruction is challenging after multilevel total spondylectomy in the cervical spine. OBJECTIVE: To illustrate the application of piezoelectric surgery and three-dimensional (3D) printing techniques in spine surgery. METHODS: A 27-yr-old patient was referred to our center with complaints of nocturnal neck pain and right upper extremity weakness. A 2-stage radical tumor resection was conducted using piezoelectric surgery with pathologically tumor-free margins. A 3D-printed titanium microporous prosthesis (3D-PTMP) was designed to reconstruct the anterior column of the cervical spine between C1 and T1 for stability. RESULTS: The whole intraoperative blood loss was 2300 mL over the 2 procedures. The patient had an uneventful recovery, regaining ambulatory status 3 wk after the 2 operations without ventilator support or other severe complications. By the final 14-mo follow-up, the patient had achieved marked pain relief and favorable neurological improvement; a postoperative computed tomography scan indicated a good position of the 3D-printed construct between the endplates with no sign of tumor recurrence or implant subsidence. CONCLUSION: The applications of piezosurgery in total spondylectomy and in 3D-PTMP in reconstruction can be a favorable alternative for managing multilevel cervical spinal tumors. Further studies are warranted to validate this surgical strategy.
BACKGROUND: Radical resection is the first-line option in managing cervical primary chondrosarcoma. Favorable anterior reconstruction is challenging after multilevel total spondylectomy in the cervical spine. OBJECTIVE: To illustrate the application of piezoelectric surgery and three-dimensional (3D) printing techniques in spine surgery. METHODS: A 27-yr-old patient was referred to our center with complaints of nocturnal neck pain and right upper extremity weakness. A 2-stage radical tumor resection was conducted using piezoelectric surgery with pathologically tumor-free margins. A 3D-printed titanium microporous prosthesis (3D-PTMP) was designed to reconstruct the anterior column of the cervical spine between C1 and T1 for stability. RESULTS: The whole intraoperative blood loss was 2300 mL over the 2 procedures. The patient had an uneventful recovery, regaining ambulatory status 3 wk after the 2 operations without ventilator support or other severe complications. By the final 14-mo follow-up, the patient had achieved marked pain relief and favorable neurological improvement; a postoperative computed tomography scan indicated a good position of the 3D-printed construct between the endplates with no sign of tumor recurrence or implant subsidence. CONCLUSION: The applications of piezosurgery in total spondylectomy and in 3D-PTMP in reconstruction can be a favorable alternative for managing multilevel cervical spinal tumors. Further studies are warranted to validate this surgical strategy.
Authors: Roberta Costanzo; Gianluca Ferini; Lara Brunasso; Lapo Bonosi; Massimiliano Porzio; Umberto Emanuele Benigno; Sofia Musso; Rosa Maria Gerardi; Giuseppe Roberto Giammalva; Federica Paolini; Paolo Palmisciano; Giuseppe Emmanuele Umana; Carmelo Lucio Sturiale; Rina Di Bonaventura; Domenico Gerardo Iacopino; Rosario Maugeri Journal: Life (Basel) Date: 2022-03-28