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Yonsei Med J. 2017 Mar;58(2):453-457. doi: 10.3349/ymj.2017.58.2.453.

Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result.

Author information

1
Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.
2
Department of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Korea.
3
Medyssey Co., Ltd., Uijeongbu, Korea.
4
Department of Pediatric Neurosurgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
5
Department of Pediatric Hemato-Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
6
Department of Neurosurgery, Guro Cham Teun Teun Hospital, Seoul, Korea.
7
Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea. cistern@yuhs.ac.

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.

KEYWORDS:

3D-printing; instrumentation; sacrum; spinal fusion

PMID:
28120579
PMCID:
PMC5290028
[Available on 2017-03-01]
DOI:
10.3349/ymj.2017.58.2.453
[Indexed for MEDLINE]
Free PMC Article

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