Vertebral Reconstruction with Customized 3-Dimensional−Printed Spine Implant Replacing Large Vertebral Defect with 3-Year Follow-up

Chung, Kyu Seon; Shin, Dong Ah; Kim, Keung Nyun; Ha, Yoon; Yoon, Do Heum; Yi, Seong‐Tae

doi:10.1016/j.wneu.2019.02.020

Cited by 24 publications

(29 citation statements)

References 17 publications

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“…21,42 An additional screw fixation system attached to the 3DP-AVB that can connect to the pedicle screws and rods system also can be designed to further strengthen the support between the anterior column and posterior column. 44 A patient-specific/individualized 3DP-AVB has been explored to fit the unique spinal pathoanatomy of complex congenital, traumatic and neoplastic pathologies. 45 Previous studies have indicated that operative time can be significantly reduced by the use of custom 3DP-AVB.…”

Section: Discussionmentioning

confidence: 99%

<p>Application of Titanium Alloy 3D-Printed Artificial Vertebral Body for Stage III Kümmell’s Disease Complicated by Neurological Deficits</p>

Dong¹,

Wei²,

Zhu³

et al. 2020

CIA

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The current study aimed to compare the clinical and radiographic results of the 3D-printed artificial vertebral body (3DP-AVB) and titanium mesh cage (TMC) for the treatment of Kümmell's disease (KD) complicated by neurological deficits. Patients and Methods: From January 2014 to July 2018, 28 consecutive patients diagnosed with KD and nerve injuries in our department were treated by posterior vertebral column resection and internal fixation. The patients were divided into two groups (3DP-AVB group and TMC group) based on the different anterior column reconstruction implants. Clinical and radiographic parameters were used to evaluate the outcomes. Results: The two groups achieved excellent clinical and radiographic results 1 month after surgery with no significant difference (P>0.05), while 3DP-AVB group showed better outcomes compared with TMC group during the follow-up after 6 months (P<0.05). The risk of subsidence in 3DP-AVB group was lower than that in TMC group (41.6% vs 87.5%, P<0.05), and severe subsidence (≥5 mm) was correlated with the recurrence of back pain and bad daily life function. No significant difference was found in the improvement of neurological function between the two groups (P>0.05). The blood loss and operation time in 3DP-AVB group were significantly less than both in TMC group (P<0.05). Conclusion: The lower incidence of cage subsidence, with a better long-term efficacy in maintaining the height of the fused segment, relieving back pain, and improving daily life function indicates that the 3DP-AVB may be a superior alternative for KD with neurological deficits.

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Section: Discussionmentioning

confidence: 99%

<p>Application of Titanium Alloy 3D-Printed Artificial Vertebral Body for Stage III Kümmell’s Disease Complicated by Neurological Deficits</p>

Dong¹,

Wei²,

Zhu³

et al. 2020

CIA

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“…According to reports, the incidence of implant-related complications is from 14.3 to 21.6% in anterior reconstruction surgery for Kümmell's disease [26] and cage subsidence is an important risk factor related to the instrumentation failure [27]. In the past few years, 3D printed artificial vertebral body with good implant fit and less subsidence has gained traction in spine surgery [28][29][30] and the excellent result may attribute to the following aspects: (1) a larger diameter endcap of 3D prosthesis allows for an expansion of the bone-implant interface, which distributes point-loading and loads the periphery of the endplates where there is thicker cortical bone, and eventually reduces the risk of subsidence [29,31]; (2) with a Young's modulus more similar to native human bone (0.5-20 GPa), may reduce subsidence and 'stress shadowing effect' compared with traditional implants [32]; (3) the porosity of 3D vertebral body made by Ti6-Al4-V titanium alloy can enhance the delivery of osteoinductive factors as well as facilitate osteoconduction, thus potentially improving bony ingrowth [29].…”

Section: Discussionmentioning

confidence: 99%

Intravertebral cleft in pathological vertebral fracture resulting from spinal tuberculosis: a case report and literature review

Dong

Zhu

et al. 2020

BMC Musculoskelet Disord

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Background Among common findings in osteoporotic vertebral compression fractures (OVCFs), the intravertebral cleft (IVC) is usually considered a benign lesion. The current study was aimed to present a rare case of vertebral fracture caused by IVC-related spinal tuberculosis. Case presentation A 73-year-old female complained of back pain and weakness in lower limbs for 2 weeks. 3 months ago, after a minor trauma, she got back pain without weakness in lower limbs. Initially, she was diagnosed with a L1 compression fracture and accepted conservative treatment. After an asymptomatic period, she complained progressive pain at the fracture position with weakness of both lower limbs and was referred to our hospital with suspicion of Kümmell’s disease. The patient underwent posterior debridement and internal fixation for decompression and stabilization of the spine. Pathological examinations revealed the patient with spinal tuberculosis. Conclusions Although IVC is common in patients with OCVFs, there are some cases believed to be found in patients with spinal tuberculosis or infection. Further test, like CT-guided puncture biopsy, may be required before decisive treatment when an IVC is observed.

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“…An encouraging development has been the emergence of small case series over the last 3 years, namely the reports from Girolami et al [6] and Wei et al [7], indicating a growing acceptance by clinicians, the potential scalability of these technologies, and the transition to higher levels of research. PSIs have now been used to manage a range of pathologies, including infection [11], degeneration [18], malignancy [19] and deformity [9], throughout the spine at the cervical [7], thoracic [19], lumbar [6] and sacral [17] levels. These cases have generally involved highly complex patho-anatomies, with a PSI indicated following the assessment of the surgical team that no commercially available generic or Off-The-Shelf (OTS) implant would provide an acceptable surgical outcome.…”

Section: Current State Of Psi Use In Spinal Surgerymentioning

confidence: 99%

“…Since the early work of D'Urso et al [4], 3DP has been extensively applied to spinal surgery, with multiple reports highlighting the utility of spinal biomodels, pedicle screw guides and PSIs [5]. PSIs in spinal surgery have become a particularly promising area, with an increasing number of case reports and small series, particularly of complex cases, emerging over the last 5 years [5][6][7][8][9][10][11][12][13][14]. Though the field is clearly at an early and formative stage, with more data required to validate this technology and its full potential likely yet to be realised, key questions about its future remain.…”

Section: Introductionmentioning

confidence: 99%

Opinion Piece: Patient-Specific Implants May Be the Next Big Thing in Spinal Surgery

Amin

Parr

Mobbs

2021

JPM

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The emergence of 3D-Printing technologies and subsequent medical applications have allowed for the development of Patient-specific implants (PSIs). There have been increasing reports of PSI application to spinal surgery over the last 5 years, including throughout the spine and to a range of pathologies, though largely for complex cases. Through a number of potential benefits, including improvements to the implant–bone interface and surgical workflow, PSIs aim to improve patient and surgical outcomes, as well as potentially provide new avenues for combating challenges routinely faced by spinal surgeons. However, obstacles to widespread acceptance and routine application include the lack of quality long-term data, research challenges and the practicalities of production and navigating the regulatory environment. While recognition of the significant potential of Spinal PSIs is evident in the literature, it is clear a number of key questions must be answered to inform future clinical and research practices. The spinal surgical community must selectively and ethically continue to offer PSIs to patients, simultaneously allowing for the necessary larger, comparative studies to be conducted, as well as continuing to provide optimal patient care, thereby ultimately determining the exact role of this technology and potentially improving outcomes.

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Vertebral Reconstruction with Customized 3-Dimensional−Printed Spine Implant Replacing Large Vertebral Defect with 3-Year Follow-up

Cited by 24 publications

References 17 publications

<p>Application of Titanium Alloy 3D-Printed Artificial Vertebral Body for Stage III Kümmell’s Disease Complicated by Neurological Deficits</p>

<p>Application of Titanium Alloy 3D-Printed Artificial Vertebral Body for Stage III Kümmell’s Disease Complicated by Neurological Deficits</p>

Intravertebral cleft in pathological vertebral fracture resulting from spinal tuberculosis: a case report and literature review

Opinion Piece: Patient-Specific Implants May Be the Next Big Thing in Spinal Surgery

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