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. 2023 May 2:11:1155470.
doi: 10.3389/fbioe.2023.1155470. eCollection 2023.

Reconstruction after hemisacrectomy with a novel 3D-printed modular hemisacrum implant in sacral giant cell tumor of the bone

Zhaorui Lv  1   2 , Jianmin Li  1 , Zhiping Yang  1 , Xin Li  1 , Qiang Yang  1 , Zhenfeng Li  1
Affiliations

Reconstruction after hemisacrectomy with a novel 3D-printed modular hemisacrum implant in sacral giant cell tumor of the bone

Zhaorui Lv et al. Front Bioeng Biotechnol. .

Abstract

Background: There are a limited but increasing number of case reports and series describing the use of 3D-printed prostheses in bone tumor surgery. Methods: We describe a new approach to performing nerve-preserving hemisacrectomy in patients with sacral giant cell tumors with reconstruction using a novel 3D-printed patient-specific modular prosthesis. The series included four female and two male patients with a mean age of 34 years (range, 28-42 years). Surgical data, imaging assessments, tumor and functional status, implant status, and complications were retrospectively analyzed in six consecutive patients. Results: In all cases, the tumor was removed by sagittal hemisacrectomy, and the prosthesis was successfully implanted. The mean follow-up time was 25 months (range, 15-32 months). All patients in this report achieved successful surgical outcomes and symptomatic relief without significant complications. Clinical and radiological follow-up showed good results in all cases. The mean MSTS score was 27.2 (range, 26-28). The average VAS was 1 (range, 0-2). No structural failures or deep infections were detected in this study at the time of follow-up. All patients had good neurological function. Two cases had superficial wound complications. Bone fusion was good with a mean fusion time of 3.5 months (range, 3-5 months). Conclusion: These cases describe the successful use of custom 3D-printed prostheses for reconstruction after sagittal nerve-sparing hemisacrectomy with excellent clinical outcomes, osseointegration, and durability.

Keywords: 3D-printed; giant cell tumor of the bone; hemisacrectomy; implant; reconstruction.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
A 3D bone tumor model from CT data was created for surgical planning (A, B). Bone defect model after tumor resection (C, D).
FIGURE 2
FIGURE 2
Design of the sacral implant. Dorsal view (A) and front view (B) of the sacral implant 3D model.
FIGURE 3
FIGURE 3
Design of the cutting guide. Dorsal view (A), side view (B), and front view (C) of the sacral implant 3D model.
FIGURE 4
FIGURE 4
Results of prosthesis implantation. Physical object of the implant (A). X-ray examination 3 years after operation (B, C). CT showing excellent osseointegration at the bone–implant junctions in axial (D), sagittal (E), and coronal (F) views.
See this image and copyright information in PMC

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