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 techn...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.展开更多
A schwannoma is a relatively common benign spinal cord tumour;however,giant schwannomas with extensive cervical vertebral erosion are rare,and the treatment strategy,especially the reconstruction of the upper cervical...A schwannoma is a relatively common benign spinal cord tumour;however,giant schwannomas with extensive cervical vertebral erosion are rare,and the treatment strategy,especially the reconstruction of the upper cervical vertebra,remains a challenge for spine surgeons.Here,we present a rare case of giant invasive high-cervical schwannoma with extensive erosion of the C2—C4 vertebral bodies and tumour-encased left vertebral artery.The surgical strategy and the reconstruction of C2—C4 with 3D printing techniques were discussed and performed.A 32-year-old man presented to our department with complaints of gait disturbance and weakness in both upper and lower extremities.His limb muscle strength was grade 2 or 3/5,and he exhibited severe bladder and bowel dysfunction on admission.X-ray and computed tomography of the cervical spine showed an extremely large erosive lesion at the C2—C4 vertebral bodies and lateral masses.Magnetic resonance imaging of the cervical spine showed a large soft-tissue mass on the left aspect of the C2—C5 vertebra and in the spinal canal at the C3—C4 level.A staged schwannoma resection,instrumented fixation,and reconstruction of C2—C4 with 3D metal printing technique were performed.The patient achieved good postoperative outcomes and returned to normal daily life with no recurrence of schwannoma during follow-up for four and a half years.The 3D-printed implant achieved solid fusion with the remaining cervical spine.We performed staged resection of the giant invasive high-cervical schwannoma and reconstructed the erosive C2—C4 vertebra with the assistance of a 3D printing technique.3D printing technology has facilitated the design and manufacture of customised implants for complex surgical procedures.展开更多
基金the National Key Research and Development Program of China(No.2017YFB1104104)the Special Foundation for Innovation of Science and Technology of Shanghai Jiao Tong University(Nos.GXQ201810 and GXQ202003)。
文摘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.
基金the National Key Research and Development Program of China(No.2017YFB1104104)the Special Foundation for Innovation of Science and Technology of Shanghai Jiao Tong University(Nos.GXQ201810 and GXQ202003)。
文摘A schwannoma is a relatively common benign spinal cord tumour;however,giant schwannomas with extensive cervical vertebral erosion are rare,and the treatment strategy,especially the reconstruction of the upper cervical vertebra,remains a challenge for spine surgeons.Here,we present a rare case of giant invasive high-cervical schwannoma with extensive erosion of the C2—C4 vertebral bodies and tumour-encased left vertebral artery.The surgical strategy and the reconstruction of C2—C4 with 3D printing techniques were discussed and performed.A 32-year-old man presented to our department with complaints of gait disturbance and weakness in both upper and lower extremities.His limb muscle strength was grade 2 or 3/5,and he exhibited severe bladder and bowel dysfunction on admission.X-ray and computed tomography of the cervical spine showed an extremely large erosive lesion at the C2—C4 vertebral bodies and lateral masses.Magnetic resonance imaging of the cervical spine showed a large soft-tissue mass on the left aspect of the C2—C5 vertebra and in the spinal canal at the C3—C4 level.A staged schwannoma resection,instrumented fixation,and reconstruction of C2—C4 with 3D metal printing technique were performed.The patient achieved good postoperative outcomes and returned to normal daily life with no recurrence of schwannoma during follow-up for four and a half years.The 3D-printed implant achieved solid fusion with the remaining cervical spine.We performed staged resection of the giant invasive high-cervical schwannoma and reconstructed the erosive C2—C4 vertebra with the assistance of a 3D printing technique.3D printing technology has facilitated the design and manufacture of customised implants for complex surgical procedures.
