菅 强,许文龙,段婉茹,刘振磊,关 健,张 璨,菅凤增,陈 赞.个体化定制3D打印假体枢椎前柱重建治疗枢椎肿瘤的疗效观察[J].中国脊柱脊髓杂志,2020,(9):804-810.
个体化定制3D打印假体枢椎前柱重建治疗枢椎肿瘤的疗效观察
中文关键词:  枢椎  3D打印  上颈椎肿瘤
中文摘要:
  【摘要】 目的:观察应用个体化定制3D打印假体重建枢椎前柱治疗枢椎肿瘤的临床疗效。方法:回顾性分析2018年12月~2019年10月我科应用个体化定制3D打印假体重建枢椎前柱治疗的6例枢椎椎体肿瘤患者的临床资料。其中男5例,女1例,年龄11~63岁,平均42.7±19.2岁。初次手术4例,其中脊索瘤2例,动脉瘤样骨囊肿1例,血管外皮细胞瘤1例;术后复发2例,均为脊索瘤。肿瘤累及椎体节段:C2节段5例,C2~C4节段1例。所有患者均行后前联合入路方式切除病变椎体。前路经口咽后壁入路5例,经下颌下咽后入路1例。所有患者均应用个体化定制3D打印颈椎假体行枢椎前柱重建。脊索瘤患者术后补充术区放疗。所有患者术后定期随访,观察肿瘤复发及内固定稳定性情况。结果:所有患者术中无神经、血管和硬脊膜损伤发生,术后患者伤口均一期愈合,无感染发生。术后平均随访11.8±3.7个月,未见肿瘤残留或复发,所有患者内固定稳定,未见螺钉松动及假体移位。结论:应用个体化定制3D打印假体能够有效重建枢椎前柱结构,获得满意的短期临床疗效。
Clinical observation on the application of customized 3D printed prosthetic body weight in the treatment of axial tumors
英文关键词:Axis  3D printing  Upper cervical tumor
英文摘要:
  【Abstract】 Objectives: To observe the clinical efficacy of customized 3D printed prostheses in the treatment of axial tumors. Methods: A retrospective study was conducted on the clinical data of 6 patients with an axial vertebral tumor treated with 3D printed prosthesis in our department from December 2018 to October 2019. There were 5 males and 1 female, aged 11-63 years, with an average age of 42.7±19.2 years. 4 cases were of primary operation, including 2 cases of chordoma, 1 case of aneurysmal bone cyst, and 1 case of hemangiopericytoma. Postoperative recurrence occurred on the 2 patients with chordoma. Vertebral segments involved by tumor: 5 patients with C2 segment and 1 patient with C2-4 segment. All patients underwent vertebral body resection via a posterior-anterior combined approach. The anterior approach was followed by transoral approach in 5 cases, and the posterior approach was followed by high retropharyngeal approach in 1 case. All patients underwent axial anterior column reconstruction with a customized 3D printed cervical prosthesis. Patients with chordoma received additional postoperative radiotherapy. All patients were followed up regularly after surgery. Results: There was no vascular and nerve injury and no dura tear. All the wounds healed in the first stage or infection occurred. The patients were followed up for 11.8±3.7 months on average, and no tumor residue or recurrence was found. The patients had stable internal fixation, with no screw loosening, nor implant displacement. Conclusions: Personalized 3D printed prosthesis can effectively reconstruct the axial anterior column structure. Satisfactory short-term clinical efficacy was obtained.
投稿时间:2020-05-15  修订日期:2020-08-10
DOI:
基金项目:首发自主创新(编号:2018-2-2014)
作者单位
菅 强 首都医科大学宣武医院神经外科 100053 北京市 
许文龙 首都医科大学宣武医院神经外科 100053 北京市 
段婉茹 首都医科大学宣武医院神经外科 100053 北京市 
刘振磊  
关 健  
张 璨  
菅凤增  
陈 赞  
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