Day Case Lumbar Fusion Surgery
A recent article published in Operative Neurosurgery explores the use of patient-specific 3-dimensional-printed implants (3DPIs) for reconstructing the lumbopelvic junction in a patient with severe neuropathic spinal arthropathy. The case involves a 61-year-old patient who had initially undergone a T4-to-sacrum spinal fusion but experienced massive bone destruction, leading to dissociation of the upper body from the pelvis and legs. Using high-resolution computed tomography scans, a custom 3DPI was created using additive titanium manufacturing. The implant consisted of a sacral platform with iliac screws, a modular corpectomy device, and an anterior plate connection for fixation. The procedure, from decision to surgical execution, lasted 28 days and provided an ideal repair of the lumbosacral junction and pelvic ring. This case demonstrates the potential of 3DPIs for personalized treatment of complex spine deformities
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established day surgery hospital in London
Published article
CONCLUSION: To the best of our knowledge, this is the first case of a multilevel lumbar, sacral, and sacropelvic neuropathic (Charcot) spine reconstruction using a 3DPI sacral prosthesis. As the prevalence of severe spine deformities continues to increase, adoption of 3DPIs is becoming more relevant to offer personalized treatment for complex deformities.
Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Oper Neurosurg (Hagerstown). 2023 Aug 16. doi: 10.1227/ons.0000000000000872. Online ahead of print.ABSTRACTBACKGROUND AND OBJECTIVE: Rapid design and production of patient-specific 3-dimensional-printed implants (3DPIs) present a novel opportunity to restore the biomechanically demanding integrity of the lumbopelvic junction. We present a unique case of a 61-year-old patient with severe neuropathic spinal arthropathy (Charcot spine) who initially,
Oper Neurosurg (Hagerstown). 2023 Aug 16. doi: 10.1227/ons.0000000000000872. Online ahead of print.
ABSTRACT
BACKGROUND AND OBJECTIVE: Rapid design and production of patient-specific 3-dimensional-printed implants (3DPIs) present a novel opportunity to restore the biomechanically demanding integrity of the lumbopelvic junction. We present a unique case of a 61-year-old patient with severe neuropathic spinal arthropathy (Charcot spine) who initially underwent a T4-to-sacrum spinal fusion. Massive bone destruction led to dissociation of his upper body from his pelvis and legs. Reconstruction of the spinopelvic continuity was planned with the aid of a personalized lumbosacral 3DPI.
METHOD: Using high-resolution computed tomography scans, the custom 3DPI was made using additive titanium manufacturing. The unique 3DPI consisted of (1) a sacral platform with iliac screws, (2) modular corpectomy device with rigid connection to the sacral platform, and (3) anterior plate connection with screws for proximal fixation. The procedures to obtain compassionate use Food and Drug Administration approval were followed. The patient underwent debridement of a chronically open wound before undertaking the 3-stage reconstructive procedure. The custom 3DPI and additional instrumentation were inserted as part of a salvage rebuilding procedure.
RESULTS: The chronology of the rapid implementation of the personalized sacral 3DPI from decision, design, manufacturing, Food and Drug Administration approval, and surgical execution lasted 28 days. The prosthesis was positioned in the defect according to the expected anatomic planes and secured using a screw-rod system and a vascularized fibular bone strut graft. The prosthesis provided an ideal repair of the lumbosacral junction and pelvic ring by merging spinal pelvic fixation, posterior pelvic ring fixation, and anterior spinal column fixation.
CONCLUSION: To the best of our knowledge, this is the first case of a multilevel lumbar, sacral, and sacropelvic neuropathic (Charcot) spine reconstruction using a 3DPI sacral prosthesis. As the prevalence of severe spine deformities continues to increase, adoption of 3DPIs is becoming more relevant to offer personalized treatment for complex deformities.
PMID:37584482 | DOI:10.1227/ons.0000000000000872
The London Spine Unit : most established day surgery hospital in London
Read the original publication:
Rapid Implementation of a 3-Dimensional-Printed Patient-Specific Titanium Sacrum Implant for Severe Neuropathic Spinal Arthropathy and Guide to Compassionate US Regulatory Approval
