个体化定制3D打印假体枢椎前柱重建治疗枢椎肿瘤的疗效观察

Clinical observation on the application of customized 3D printed prosthetic body weight in the treatment of axial tumors

中文关键词:  枢椎  3D打印  上颈椎肿瘤

英文关键词:Axis  3D printing  Upper cervical tumor

中文摘要:

  【摘要】 目的：观察应用个体化定制3D打印假体重建枢椎前柱治疗枢椎肿瘤的临床疗效。方法：回顾性分析2018年12月～2019年10月我科应用个体化定制3D打印假体重建枢椎前柱治疗的6例枢椎椎体肿瘤患者的临床资料。其中男5例，女1例，年龄11～63岁，平均42.7±19.2岁。初次手术4例，其中脊索瘤2例，动脉瘤样骨囊肿1例，血管外皮细胞瘤1例；术后复发2例，均为脊索瘤。肿瘤累及椎体节段：C2节段5例，C2～C4节段1例。所有患者均行后前联合入路方式切除病变椎体。前路经口咽后壁入路5例，经下颌下咽后入路1例。所有患者均应用个体化定制3D打印颈椎假体行枢椎前柱重建。脊索瘤患者术后补充术区放疗。所有患者术后定期随访，观察肿瘤复发及内固定稳定性情况。结果：所有患者术中无神经、血管和硬脊膜损伤发生，术后患者伤口均一期愈合，无感染发生。术后平均随访11.8±3.7个月，未见肿瘤残留或复发，所有患者内固定稳定，未见螺钉松动及假体移位。结论：应用个体化定制3D打印假体能够有效重建枢椎前柱结构，获得满意的短期临床疗效。

英文摘要:

  【Abstract】 Objectives: To observe the clinical efficacy of customized 3D printed prostheses in the treatment of axial tumors. Methods: A retrospective study was conducted on the clinical data of 6 patients with an axial vertebral tumor treated with 3D printed prosthesis in our department from December 2018 to October 2019. There were 5 males and 1 female, aged 11-63 years, with an average age of 42.7±19.2 years. 4 cases were of primary operation, including 2 cases of chordoma, 1 case of aneurysmal bone cyst, and 1 case of hemangiopericytoma. Postoperative recurrence occurred on the 2 patients with chordoma. Vertebral segments involved by tumor: 5 patients with C2 segment and 1 patient with C2-4 segment. All patients underwent vertebral body resection via a posterior-anterior combined approach. The anterior approach was followed by transoral approach in 5 cases, and the posterior approach was followed by high retropharyngeal approach in 1 case. All patients underwent axial anterior column reconstruction with a customized 3D printed cervical prosthesis. Patients with chordoma received additional postoperative radiotherapy. All patients were followed up regularly after surgery. Results: There was no vascular and nerve injury and no dura tear. All the wounds healed in the first stage or infection occurred. The patients were followed up for 11.8±3.7 months on average, and no tumor residue or recurrence was found. The patients had stable internal fixation, with no screw loosening, nor implant displacement. Conclusions: Personalized 3D printed prosthesis can effectively reconstruct the axial anterior column structure. Satisfactory short-term clinical efficacy was obtained.