Three-Dimensional Printing-Assisted Cervical Anterior Bilateral Pedicle Screw Fixation of Artificial Vertebral Body for Cervical Tuberculosis

Zhang, Yuan‐Wei; Deng, Liang; Zhang, Xiaoxiang; Yu, Xingliang; Ai, Zi-Zheng; Mei, Yu-Xiang; He, Fei; Yu, Huan; Liang, Zhang; Xiao, Xin; Xiao, Youping; Chen, Xi; Zhang, Suli; Ge, Hong-Yan; Xing, Dong

doi:10.1016/j.wneu.2019.03.238

Cited by 31 publications

(20 citation statements)

References 21 publications

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“…It had been reported that preoperative 3D models can help surgeons plan operations, assist young doctors in learning surgical methods, and enhance communication between patients and surgeons ( Liu et al, 2020 ). Moreover, preoperative 3D printed models, surgical guide plates, and customized implants in orthopedic clinical application exhibited significant advantage, including the individual customization, rapid manufacturing, and efficient intraoperative drilling and osteotomy ( Zhang et al, 2019a , b ; Dong et al, 2020 ). In present study, assisted 3D printed model showed the focus of thoracic tuberculosis and the destruction of vertebral bodies directly, which could enhance the comprehension of spinal tuberculosis and the necessity of surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Evaluation and the Assisted 3D Printed Model in the Patient-Specific Preoperative Planning for Thoracic Spinal Tuberculosis: A Finite Element Analysis

Wang

Hua

et al. 2020

Front. Bioeng. Biotechnol.

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Posterior fixation is superior to anterior fixation in the correction of kyphosis and maintenance of spinal stability for the treatment of thoracic spinal tuberculosis. However, the process of selecting the appropriate spinal fixation method remains controversial, and preoperative biomechanical evaluation has not yet been investigated. In this study, we aimed to analyze the application of the assisted finite element analysis (FEA) and the three-dimensional (3D) printed model for the patient-specific preoperative planning of thoracic spinal tuberculosis. An adult patient with thoracic spinal tuberculosis was included. A finite element model of the T7−T11 thoracic spine segments was reconstructed to analyze the biomechanical effect of four different operative constructs. The von Mises stress values of the implants in the vertical axial load and flexion and extension conditions under a 400-N vertical axial pre-load and a 10-N⋅m moment were calculated and compared. A 3D printed model was used to describe and elucidate the patient’s condition and simulate the optimal surgical design. According to the biomechanical evaluation, the patient-specific preoperative surgical design was prepared for implementation. The anterior column, which was reconstructed with titanium alloy mesh and a bone graft with posterior fixation using seven pedicle screws (M+P) and performed at the T7–T11 level, decreased the von Mises stress placed on the right rod, T7 pedicle screw, and T11 pedicle. Moreover, the M+P evaded the left T9 screw without load bearing. The 3D printed model and preoperative surgical simulation enhanced the understanding of the patient’s condition and facilitated patient-specific preoperative planning. Good clinical results, including no complication of implants, negligible loss of the Cobb angle, and good bone fusion, were achieved using the M+P surgical design. In conclusion, M+P was recommended as the optimal method for preoperative planning since it enabled the preservation of the normal vertebra and prevented unnecessary internal fixation. Our study indicated that FEA and the assisted 3D printed model are tools that could be extremely useful and effective in the patient-specific preoperative planning for thoracic spinal tuberculosis, which can facilitate preoperative surgical simulation and biomechanical evaluation, as well as improve the understanding of the patient’s condition.

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Section: Discussionmentioning

confidence: 99%

Biomechanical Evaluation and the Assisted 3D Printed Model in the Patient-Specific Preoperative Planning for Thoracic Spinal Tuberculosis: A Finite Element Analysis

Wang

Hua

et al. 2020

Front. Bioeng. Biotechnol.

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“…This case demonstrates the feasibility of using 3D printing to develop customised reconstructive implants. In addition to producing individually unique anatomical matches, 3D-printed patient-specific implants showed functional properties in the treatment of spine infections, complex revision surgery, upper cervical degenerative pathology, and osteoporotic fracture-related spinal deformity [13][14][15]42] .…”

Section: D-printed Customized Implants 131 3d-printed Vertebral Body For Reconstructionmentioning

confidence: 99%

“…This new technology can efficiently convert digital 3D model information, such as that in standard tessellation language (STL) files, into physical objects. Due to its advantages in design and manufacturing, 3D printing has been adopted in a vast range of applications in spine surgery, including producing anatomical models [1][2][3] , surgical templates [4][5][6][7][8] , preoperative planning [9][10][11] , and patient-specific spinal implants [12][13][14][15][16][17][18][19] . In addition to its advantages in manufacturing anatomically adapted implants, 3D printing technology is also being used to optimise the structural properties of premade off-theshelf medical products [20] .…”

Section: Introductionmentioning

confidence: 99%

Progress in the Application of 3D Printing Technology in Spine Surgery

Sun

Yang

Zhao

et al. 2021

J. Shanghai Jiaotong Univ. (Sci.)

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We are in the midst of exciting advancements in new technologies and innovative research in precision medicine. Among these, 3D printing is one of the most frequently seen in clinical orthopaedic settings. This new technique has been adopted in a vast range of applications in spine surgery, such as producing anatomical models, surgical templates, preoperative plans, and spinal implants. Some studies on 3D printing technologies in spine surgery have reported the benefits of this emerging technology with more effective manufacturing, more visualisation for communication, and more precise navigation for screw insertion and osteotomy. In addition, in customised implant design and fabrication processes, 3D printing products with anatomical adaptions and complex porous microstructure show some attractive advantages in terms of fit and osteoinductivity. However, there are still some concerns about the safety and feasibility of the application of 3D printing technology in spine surgery. We review the literature on and share our experiences with the application of 3D printing from the beginning of collaborations between doctors and computer-aided design (CAD) designers to the final follow-up of clinical patients.

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“…The stress distribution of the artificial vertebral body was more dispersed and balanced than that of the anterior titanium and mesh system, and the risks of internal fixation fracture and implant subsidence might be lower. In addition, Zhang et al [28] designed and applied a new type of 3-dimensional (3D) printing assisted anterior bilateral pedicle screws fixation of the artificial vertebral body to a patient with cervical tuberculosis and obtained excellent clinical outcomes and realized the ultra-short segment fixation of the diseased vertebrae. Besides, compared with the conventional titanium and mesh group by the FEA, it was found that the fixation stress of artificial vertebral body group was more uniformly dispersed and balanced, which could effectively prevent the degeneration of adjacent vertebral bodies and intervertebral discs.…”

Section: Distinctive Instruments For Atps Fixationmentioning

confidence: 99%

“…( C ) Designed by Wu et al [27]. ( D ) Designed by Zhang et al [28]. ATPS – anterior transpedicular screws.…”

Section: Figurementioning

confidence: 99%

Progress of the Anterior Transpedicular Screw in Lower Cervical Spine: A Review

Zhang

Gao

et al. 2019

Med Sci Monit

Self Cite

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The anterior transpedicular screws (ATPS) fixation is a valuable discovery in the field of lower cervical spine (LCS) reconstruction, as it has the advantages of both anterior and posterior approaches. In recent years, with in-depth research on ATPS fixation related to anatomy, biomechanical tests, and clinical applications, its firm stability and excellent biomechanical properties have been recognized by more and more surgeons. Although ATPS fixation has been gradually applied in clinic settings under the promotion of emerging distinctive instruments, its long-term efficacy still needs to be further clarified due to the lack of large sample size studies and long-term follow-up. Nevertheless, it is believed that with the maturity of digital devices and the development of precision medicine, ATPS fixation has a promising prospect.

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Three-Dimensional Printing-Assisted Cervical Anterior Bilateral Pedicle Screw Fixation of Artificial Vertebral Body for Cervical Tuberculosis

Cited by 31 publications

References 21 publications

Biomechanical Evaluation and the Assisted 3D Printed Model in the Patient-Specific Preoperative Planning for Thoracic Spinal Tuberculosis: A Finite Element Analysis

Biomechanical Evaluation and the Assisted 3D Printed Model in the Patient-Specific Preoperative Planning for Thoracic Spinal Tuberculosis: A Finite Element Analysis

Progress in the Application of 3D Printing Technology in Spine Surgery

Progress of the Anterior Transpedicular Screw in Lower Cervical Spine: A Review

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