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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

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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.

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Acknowledgements

Authors acknowledge the invaluable contribution of Cristiana Griffoni and Carlo Piovani for patient storage and data collection.

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Authors and Affiliations

  1. Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via G.C. Pupilli, 1, 40136, Bologna, Italy

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

  2. IRCCS Galeazzi Orthopedic Institute, Milan, Italy

    Stefano Boriani

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  1. Marco Girolami
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  2. Stefano Boriani
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  3. Stefano Bandiera
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  4. Giovanni Barbanti-Bródano
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  5. Riccardo Ghermandi
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  6. Silvia Terzi
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  10. Alessandro Gasbarrini
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Correspondence to Marco Girolami.

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Girolami, M., Boriani, S., Bandiera, S. et al. Biomimetic 3D-printed custom-made prosthesis for anterior column reconstruction in the thoracolumbar spine: a tailored option following en bloc resection for spinal tumors. Eur Spine J 27, 3073–3083 (2018). https://doi.org/10.1007/s00586-018-5708-8

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  • DOI: https://doi.org/10.1007/s00586-018-5708-8

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