Reconstruction of the Upper Cervical Spine Using a Personalized 3D-Printed Vertebral Body in an Adolescent With Ewing Sarcoma

Xu, Nanfang; Wei, Feng; Liu, Xiaoguang; Jiang, Liang; Cai, Hong; He, Jingliang; Yu, Miao; Wu, Fan; Liu, Zhongjun

doi:10.1097/brs.0000000000001179

Cited by 259 publications

(201 citation statements)

References 19 publications

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“…Other applications of 3DP in orthopaedics include the use of customized external fixators to assist with fracture reduction (14) and 3D printed casts. 3DP has also been described in musculoskeletal tumour excision with Chinese surgeons recently replacing a segment of cancerous cervical vertebrae in a 12-year-old patient with a C2 Ewing sarcoma with a 3DP titanium customised vertebral body (15). Similar to the presented case, this case study utilised a titanium alloy powder as the main component within the final implanted device.…”

Section: Discussionmentioning

confidence: 77%

“…The use of porous titanium in screws has previously been demonstrated to support and facilitate osteo-integration and eventual arthrodesis through optimising the bonemetal interface (16), commonly utilised in a range of FDA approved total disc replacement devices, fusion cages, and pedicle screws (17). In our case, additional autograft was utilised due to its availability to aid with arthrodesis across the C1/C2 segment, although it is hypothesised that with an increase in the quality of implant design and improvements in biomaterials, the requirement of further grafting may soon be unnecessary (15). The current authors believe that the use of autograft and bone graft substitutes may eventually be unnecessary with use for arthrodesis and implant integration, as developments in biomaterials and 3DP continues to advance.…”

Section: Discussionmentioning

confidence: 96%

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Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis

Phan

Sgrò²,

Maharaj

et al. 2016

J. Spine Surg.

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The study aims to describe a three-dimensional printed (3DP) posterior fixation implant used for C1/ C2 fusion in a 65-year-old female. Spinal fusion remains a common intervention for a range of spinal pathologies including degenerative disc and facet disease when conservative methods are unsuccessful.However, fusion devices are not always entirely efficacious in providing the desired fixation, and surgeons rely on 'off the shelf' implants which may not provide an anatomical fit to address the particular pathology.3DP refers to a process where three-dimensional objects are created through successive layering of material, so called 'additive manufacturing'. Although this technology enables accurate fabrication of patient-specific orthopaedic and spinal implants, literature on its utilization in this regard is rare. A 65-year-old female, with severe facet arthropathy at the C1/C2 level, osteophyte formation and impingement of the exiting C2 nerve root underwent a C1/C2 posterior fusion and rhizolysis of the C2 nerve roots. A custom posterior fixation implant was designed and on-laid over the C2 spinous process and lamina, with screw holes made to a depth and angulation that was pre-calculated based on the preoperative CT based 3D modelling. The patient had an uneventful recovery and reported a significant reduction in occipital neuralgia and sub-occipital pain and 2-month follow-up. We report the first case of a customized 3DP spinal prosthesis for posterior C1/ C2 fusion. The implant added significant value reducing the overall time of the procedure, and safety with a reduced risk of neurovascular compromise.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 96%

Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis

Phan

Sgrò²,

Maharaj

et al. 2016

J. Spine Surg.

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“…Besides, favorable hemocompatibility and absorbability are also principal demands when the materials contact with blood [42]. 3D printed customized porous Ti6Al4V implants with interconnected macropores and high porosity can easily meet the requirements of osteoconduction and stability for its patient-specific design and bone in-growth properties [43,44]. In addition, the additive manufacturing technology has good flexibility, reproducibility and high cost-effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Polydopamine-assisted functionalization of heparin and vancomycin onto microarc-oxidized 3D printed porous Ti6Al4V for improved hemocompatibility, osteogenic and anti-infection potencies

et al. 2018

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“…The cases performed thus far are limited to anatomically challenging, rare pathologies where an individualized solution to restore patient-specific anatomy is a key prognostic factor (44,(46)(47)(48)59,60). These range from customised fixation in the upper cervical and lower lumbar spine (44,48,59) to insertion of a 3DP vertebra (46) and sacral reconstructions (45,47).…”

Section: Customised Implantsmentioning

confidence: 99%

Systematic review of 3D printing in spinal surgery: the current state of play

et al. 2017

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Three-dimensional printing (3DP), also known as "Additive Manufacturing", is a rapidly growing industry, particularly in the area of spinal surgery. Given the complex anatomy of the spine and delicate nature of surrounding structures, 3DP has the potential to aid surgical planning and procedural accuracy. We perform a systematic review of current literature on the applications of 3DP in spinal surgery. Six electronic databases were searched for original published studies reporting cases or outcomes for 3DP surgical models, guides or implants for spinal surgery. The findings of these studies were synthesized and summarized. These searches returned a combined 2,411 articles. Of these, 54 were included in this review. 3DP is currently used for surgical planning, intra-operative surgical guides, customised prostheses as well as "Off-the-Shelf" implants. The technology has the potential for enhanced implant properties, as well as decreased surgical time and better patient outcomes. The majority of the data thus far is from low-quality studies with inherent biases linked with the excitement of a new field. As the body of literature continues to expand, larger scale studies to evaluate advantages and disadvantages, and longer-term follow up will enhance our knowledge of the effect 3DP has in spinal surgery. In addition, issues such as financial impact, time to design and print, materials selection and bio-printing will evolve as this rapidly expanding field matures.

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Reconstruction of the Upper Cervical Spine Using a Personalized 3D-Printed Vertebral Body in an Adolescent With Ewing Sarcoma

Cited by 259 publications

References 19 publications

Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis

Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis

Polydopamine-assisted functionalization of heparin and vancomycin onto microarc-oxidized 3D printed porous Ti6Al4V for improved hemocompatibility, osteogenic and anti-infection potencies

Systematic review of 3D printing in spinal surgery: the current state of play

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