Biomimetic 3D-printed custom-made prosthesis for anterior column reconstruction in the thoracolumbar spine

a tailored option following en bloc resection for spinal tumors: Preliminary results on a case-series of 13 patients

Marco Girolami, Stefano Boriani, Stefano Bandiera, Giovanni Barbanti-Bródano, Riccardo Ghermandi, Silvia Terzi, Giuseppe Tedesco, Gisberto Evangelisti, Valerio Pipola, Alessandro Gasbarrini

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Various techniques for anterior column reconstruction have been described after en bloc resection of spinal tumors. Limited evidence exists regarding one being superior to another. The purpose of this study is to evaluate 3D-printed vertebral bodies for spinal reconstruction after en bloc resection in the thoracolumbar spine. Methods: Prospective observational study on custom-made 3D-printed titanium reconstruction of vertebral bodies after en bloc resection for spinal tumor was conducted between November 2015 and June 2017. 3D-printed vertebral bodies were monitored for mechanical complications such as (1) migration, (2) subsidence into the adjacent vertebral bodies, and/or (3) breakage. Complications and related details were recorded. Results: Thirteen patients (7 females and 6 males) were enrolled, and reconstruction of the anterior column was performed using custom-made 3D-printed titanium prosthesis after en bloc resection for spinal tumor (8 primary bone tumors and 5 solitary metastases). Subsidence into the adjacent vertebral bodies occurred in all patients at both proximal and distal bone–implant interfaces; however, it was clinically irrelevant (asymptomatic, and no consequences on posterior instrumentation), in 11 out of 12 patients (92%). In 1 patient (#4), severity of the subsidence led to revision of the construct. At an average 10-month follow-up (range 2–16), 1 implant was removed due to local recurrence of the disease and 1 was revisioned due to progressive distal junctional kyphosis. Conclusion: Preliminary results from this series suggest that 3D printing can be effectively used to produce custom-made prosthesis for anterior column reconstruction. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

Original languageEnglish
Pages (from-to)3073
Number of pages3083
JournalEuropean Spine Journal
Volume27
Issue number12
DOIs
Publication statusPublished - Dec 2018

Fingerprint

Biomimetics
Prostheses and Implants
Spine
Titanium
Neoplasms
Kyphosis
Observational Studies
Prospective Studies
Neoplasm Metastasis
Bone and Bones
Recurrence

Keywords

  • 3D printing
  • En bloc resection
  • Metastases
  • Primary bone tumor
  • Spinal reconstruction
  • Spinal tumors
  • Spine surgery

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{e62917f7ee0a4239b83e63a01ba6d6c4,
title = "Biomimetic 3D-printed custom-made prosthesis for anterior column reconstruction in the thoracolumbar spine: a tailored option following en bloc resection for spinal tumors: Preliminary results on a case-series of 13 patients",
abstract = "Purpose: Various techniques for anterior column reconstruction have been described after en bloc resection of spinal tumors. Limited evidence exists regarding one being superior to another. The purpose of this study is to evaluate 3D-printed vertebral bodies for spinal reconstruction after en bloc resection in the thoracolumbar spine. Methods: Prospective observational study on custom-made 3D-printed titanium reconstruction of vertebral bodies after en bloc resection for spinal tumor was conducted between November 2015 and June 2017. 3D-printed vertebral bodies were monitored for mechanical complications such as (1) migration, (2) subsidence into the adjacent vertebral bodies, and/or (3) breakage. Complications and related details were recorded. Results: Thirteen patients (7 females and 6 males) were enrolled, and reconstruction of the anterior column was performed using custom-made 3D-printed titanium prosthesis after en bloc resection for spinal tumor (8 primary bone tumors and 5 solitary metastases). Subsidence into the adjacent vertebral bodies occurred in all patients at both proximal and distal bone–implant interfaces; however, it was clinically irrelevant (asymptomatic, and no consequences on posterior instrumentation), in 11 out of 12 patients (92{\%}). In 1 patient (#4), severity of the subsidence led to revision of the construct. At an average 10-month follow-up (range 2–16), 1 implant was removed due to local recurrence of the disease and 1 was revisioned due to progressive distal junctional kyphosis. Conclusion: Preliminary results from this series suggest that 3D printing can be effectively used to produce custom-made prosthesis for anterior column reconstruction. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].",
keywords = "3D printing, En bloc resection, Metastases, Primary bone tumor, Spinal reconstruction, Spinal tumors, Spine surgery",
author = "Marco Girolami and Stefano Boriani and Stefano Bandiera and Giovanni Barbanti-Br{\'o}dano and Riccardo Ghermandi and Silvia Terzi and Giuseppe Tedesco and Gisberto Evangelisti and Valerio Pipola and Alessandro Gasbarrini",
year = "2018",
month = "12",
doi = "10.1007/s00586-018-5708-8",
language = "English",
volume = "27",
pages = "3073",
journal = "European Spine Journal",
issn = "0940-6719",
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TY - JOUR

T1 - Biomimetic 3D-printed custom-made prosthesis for anterior column reconstruction in the thoracolumbar spine

T2 - a tailored option following en bloc resection for spinal tumors: Preliminary results on a case-series of 13 patients

AU - Girolami, Marco

AU - Boriani, Stefano

AU - Bandiera, Stefano

AU - Barbanti-Bródano, Giovanni

AU - Ghermandi, Riccardo

AU - Terzi, Silvia

AU - Tedesco, Giuseppe

AU - Evangelisti, Gisberto

AU - Pipola, Valerio

AU - Gasbarrini, Alessandro

PY - 2018/12

Y1 - 2018/12

N2 - Purpose: Various techniques for anterior column reconstruction have been described after en bloc resection of spinal tumors. Limited evidence exists regarding one being superior to another. The purpose of this study is to evaluate 3D-printed vertebral bodies for spinal reconstruction after en bloc resection in the thoracolumbar spine. Methods: Prospective observational study on custom-made 3D-printed titanium reconstruction of vertebral bodies after en bloc resection for spinal tumor was conducted between November 2015 and June 2017. 3D-printed vertebral bodies were monitored for mechanical complications such as (1) migration, (2) subsidence into the adjacent vertebral bodies, and/or (3) breakage. Complications and related details were recorded. Results: Thirteen patients (7 females and 6 males) were enrolled, and reconstruction of the anterior column was performed using custom-made 3D-printed titanium prosthesis after en bloc resection for spinal tumor (8 primary bone tumors and 5 solitary metastases). Subsidence into the adjacent vertebral bodies occurred in all patients at both proximal and distal bone–implant interfaces; however, it was clinically irrelevant (asymptomatic, and no consequences on posterior instrumentation), in 11 out of 12 patients (92%). In 1 patient (#4), severity of the subsidence led to revision of the construct. At an average 10-month follow-up (range 2–16), 1 implant was removed due to local recurrence of the disease and 1 was revisioned due to progressive distal junctional kyphosis. Conclusion: Preliminary results from this series suggest that 3D printing can be effectively used to produce custom-made prosthesis for anterior column reconstruction. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

AB - Purpose: Various techniques for anterior column reconstruction have been described after en bloc resection of spinal tumors. Limited evidence exists regarding one being superior to another. The purpose of this study is to evaluate 3D-printed vertebral bodies for spinal reconstruction after en bloc resection in the thoracolumbar spine. Methods: Prospective observational study on custom-made 3D-printed titanium reconstruction of vertebral bodies after en bloc resection for spinal tumor was conducted between November 2015 and June 2017. 3D-printed vertebral bodies were monitored for mechanical complications such as (1) migration, (2) subsidence into the adjacent vertebral bodies, and/or (3) breakage. Complications and related details were recorded. Results: Thirteen patients (7 females and 6 males) were enrolled, and reconstruction of the anterior column was performed using custom-made 3D-printed titanium prosthesis after en bloc resection for spinal tumor (8 primary bone tumors and 5 solitary metastases). Subsidence into the adjacent vertebral bodies occurred in all patients at both proximal and distal bone–implant interfaces; however, it was clinically irrelevant (asymptomatic, and no consequences on posterior instrumentation), in 11 out of 12 patients (92%). In 1 patient (#4), severity of the subsidence led to revision of the construct. At an average 10-month follow-up (range 2–16), 1 implant was removed due to local recurrence of the disease and 1 was revisioned due to progressive distal junctional kyphosis. Conclusion: Preliminary results from this series suggest that 3D printing can be effectively used to produce custom-made prosthesis for anterior column reconstruction. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

KW - 3D printing

KW - En bloc resection

KW - Metastases

KW - Primary bone tumor

KW - Spinal reconstruction

KW - Spinal tumors

KW - Spine surgery

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