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CLINICAL CASE STUDY

3D-Printed Patient-Customized Artificial Vertebral

Body for Spinal Reconstruction after Total En Bloc

Spondylectomy of Complex Multi-Level Spinal Tumors

Xianglin Hu , Shachar Kenan , Mo Cheng , Weiluo Cai , Wending Huang *, Wangjun Yan *
1,2
1,2
1,2
1,2
1,2
3
1 Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
3 Department of Orthopedic Surgery, North Shore-Long Island Jewish Hospital, Northwell Health Medical Center,
New York, United States
Abstract: Three dimensional (3D)-printing technology facilitates complex spine surgery with unique advantages in artificial
vertebral body design and manufacturing. In this study, we aimed to demonstrate how a 3D-printed spinal implant is utilized
in the management of multi-level spinal tumors and integrates with comprehensive oncologic treatment. Eight spinal or
paraspinal tumor patients requiring spinal reconstruction after total en bloc spondylectomy were selected as candidates for
3D-printed titanium artificial vertebral body implants. All patients underwent surgery on three or more vertebral segments or
complex spinal junction segments. The clinical, oncological, and surgical characteristics of patients were collected. Of the
eight candidates, seven suffered from pain and/or limb disorder. Six underwent successful 3D-printed spinal implantation,
while two failed due to implant mismatching and were converted to conventional reconstruction. Of the six patients undergoing
3D-printed spinal implant surgery: (i) Five had recurrent tumors; (ii) three underwent neoadjuvant therapy; (iii) the median
surgery time was 414 min; (iv) the median blood loss was 2150 ml; (v) the median blood transfusion was 2000 ml; (vi) the
median length of hospital stay was 9 days; (vii) four patients received adjuvant therapy after surgery; and (viii) all patients
experienced no pain, moved freely, and had no local recurrence at a median of 11.5 months post-operative follow-up. Spinal
reconstruction with a 3D-printed titanium artificial vertebral body allows for total en bloc resection of complex multi-level
spinal tumors. Combined with neoadjuvant and adjuvant therapy, these patients had excellent postoperative outcomes, long-
term normal spinal function, and associated low local recurrence probability.
Keywords: 3D printing; Artificial vertebral body; Spinal tumor; Total en bloc spondylectomy; Adjuvant therapy;
Multi-disciplinary team

*Correspondence to: Wending Huang, Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology,
Shanghai Medical College, Fudan University, Shanghai 200032, China; orienthwd@163.com; Wangjun Yan, Department of Musculoskeletal Surgery, Fudan
University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; yanwj@fudan.edu.cn.

Received: February 22, 2022; Accepted: March 21, 2022; Published Online: May 31, 2022
Citation: Hu X, Kenan S, Cheng M., et al., 2022, 3D-Printed Patient-Customized Artificial Vertebral Body for Spinal
Reconstruction after Total En Bloc Spondylectomy of Complex Multi-Level Spinal Tumors. Int J Bioprint, 8(3):576.
http://doi.org/10.18063/ijb.v8i3.576

1. Introduction applications of this technology involves restoration of
bone defects after resection, which provides maximum
Three-dimensional (3D) printing, also known as bone contact surface for reconstruction. In addition,
additive manufacturing, has unique advantages in 3D-printed orthopedic implants can mimic cortical
orthopedic implant design and manufacturing [1,2] . and cancellous bone by integration of solid and porous
3D-printed orthopedic implants are customized based on elements, thus promoting bone fusion and long-term
patient-specific preoperative imaging data. One of the stability [3,4] .

© 2022 Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution License, permitting distribution, and
reproduction in any medium, provided the original work is properly cited.
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