医学                        
                
                                
                        
                            椎体切除术                        
                
                                
                        
                            植入                        
                
                                
                        
                            矢状面                        
                
                                
                        
                            冠状面                        
                
                                
                        
                            3d打印                        
                
                                
                        
                            外科                        
                
                                
                        
                            畸形                        
                
                                
                        
                            神经外科                        
                
                                
                        
                            椎骨                        
                
                                
                        
                            胸椎                        
                
                                
                        
                            脊柱侧凸                        
                
                                
                        
                            椎体                        
                
                                
                        
                            放射科                        
                
                                
                        
                            腰椎                        
                
                                
                        
                            切除术                        
                
                                
                        
                            腰椎                        
                
                                
                        
                            生物医学工程                        
                
                        
                    
            作者
            
                Wen Jie Choy,Ralph J. Mobbs,Ben Wilcox,Steven Phan,Kevin Phan,Chester E. Sutterlin            
         
                    
        
    
            
            标识
            
                                    DOI:10.1016/j.wneu.2017.05.133
                                    
                                
                                 
         
        
                
            摘要
            
            Neurosurgery and spine surgery have the potential to benefit from the use of 3-dimensional printing (3DP) technology due to complex anatomic considerations and the delicate nature of surrounding structures. We report a procedure that uses a 3D-printed titanium T9 vertebral body implant post T9 vertebrectomy for a primary bone tumor.A 14-year-old female presented with progressive kyphoscoliosis and a pathologic fracture of the T9 vertebra with sagittal and coronal deformity due to a destructive primary bone tumor. Surgical resection and reconstruction was performed in combination with a 3D-printed, patient-specific implant. Custom design features included porous titanium end plates, corrective angulation of the implant to restore sagittal balance, and pedicle screw holes in the 3D implant to assist with insertion of the device. In addition, attachment of the anterior column construct to the posterior pedicle screw construct was possible due to the customized features of the patient-specific implant.An advantage of 3DP is the ability to manufacture patient-specific implants, as in the current case example. Additionally, the use of 3DP has been able to reduce operative time significantly. Surgical procedures can be preplanned using 3DP patient-specific models. Surgeons can train before performing complex procedures, which enhances their presurgical planning in order to maximize patient outcomes. When considering implants and prostheses, the use of 3DP allows a superior anatomic fit for the patient, with the potential to improve restoration of anatomy.
         
            
 
                 
                
                    
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