Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result.
10.3349/ymj.2017.58.2.453
- Author:
Doyoung KIM
1
;
Jun Young LIM
;
Kyu Won SHIM
;
Jung Woo HAN
;
Seong YI
;
Do Heum YOON
;
Keung Nyun KIM
;
Yoon HA
;
Gyu Yeul JI
;
Dong Ah SHIN
Author Information
1. Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea. cistern@yuhs.ac
- Publication Type:Case Report
- Keywords:
3D-printing;
sacrum;
instrumentation;
spinal fusion
- MeSH:
Drug Therapy;
Follow-Up Studies*;
Foot;
Humans;
Osteosarcoma*;
Pain, Postoperative;
Prostheses and Implants;
Sacrum;
Spinal Diseases;
Spinal Fusion;
Titanium;
Weight-Bearing
- From:Yonsei Medical Journal
2017;58(2):453-457
- CountryRepublic of Korea
- Language:English
-
Abstract:
Pelvic reconstruction after sacral resection is challenging in terms of anatomical complexity, excessive loadbearing, and wide defects. Nevertheless, the technological development of 3D-printed implants enables us to overcome these difficulties. Here, we present a case of sacral osteosarcoma surgically treated with hemisacrectomy and sacral reconstruction using a 3D-printed implant. The implant was printed as a customized titanium prosthesis from a 3D real-sized reconstruction of a patient's CT images. It consisted mostly of a porous mesh and incorporated a dense strut. After 3-months of neoadjuvant chemotherapy, the patient underwent hemisacretomy with preservation of contralateral sacral nerves. The implant was anatomically installed on the defect and fixed with a screw-rod system up to the level of L3. Postoperative pain was significantly low and the patient recovered sufficiently to walk as early as 2 weeks postoperatively. The patient showed left-side foot drop only, without loss of sphincter function. In 1-year follow-up CT, excellent bony fusion was noticed. To our knowledge, this is the first report of a case of hemisacral reconstruction using a custom-made 3D-printed implant. We believe that this technique can be applied to spinal reconstructions after a partial or complete spondylectomy in a wide variety of spinal diseases.
