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The World's First 3D Print Made The Titanium Vertebral Body
Aug 12, 2017

The cervical vertebra is wrapped up in a huge tumor of 6 vertebrae, and is crawled along the cervical spine laterally into a number of segments, transverse processes, small joints, the spinal canal and the large vessels beside the vertebral canal, and the common carotid arteries, which severely squeeze the spinal cord, trachea, and esophagus...... What is more difficult is that the existing titanium mesh and titanium plate internal fixation instruments can not meet the reconstruction of the super long segment defect after resection. Recently, Second Military Medical University bone tumor surgery (Changzheng Hospital Cancer Center, Changzheng spine) Professor Xiao Jianru research team, the integration of the world's first 3D printing application of prosthetic titanium alloy 6 vertebrae plate design for reconstruction of the defect area of spinal chordoma after long segmental huge success, refresh the world's longest cervical vertebra tumor resection and reconstruction of the record.

From Hunan, 40 year old Ms. Zhou suffering from cervical chordoma for 7 years, which has experienced two times of recurrence after surgery, the recent unfortunate recurrence. With the increasing tumor in the neck, severe compression of the trachea and esophagus, Ms. Zhou breathing and eating has become a problem, and even holding chopsticks and other routine movements are becoming increasingly difficult. This is an aggressive, low grade tumor with a high recurrence rate and occurs in the occipital, cervical, and sacral regions.

Years of pain and suffering to Ms. Zhou many times to end my life, old old parents thought, a daughter cry piteously for food during which she took ill, traveled to the large and small hospitals, are due to the complexity of the disease, surgery is difficult. Finally, she attracted experts at the recommendation of the director Xiao Jianru came to Shanghai to find a bone tumor surgery, Changzheng hospital.

The NMR magnetic inspection showed that: Ms. Zhou suffered from cervical chordoma has eroded section 3-7 and first thoracic section, more serious is that large tumors on both sides of the front of the vertebral artery and common carotid artery, internal and external carotid artery and internal jugular vein tightly wrapped. In addition, due to the initial surgery of unilateral vertebral artery ligation has been so wrapped around the tumor block, on the other side of the dominant vertebral artery for blood supply to the brain is critical, reoperation once the damage will lead to a serious shortage of life-threatening blood brain stem. For the difficult cases of this rare, plus cervical anatomy in thoracolumbar spine is more complex, the difficulty of operation as can be imagined. Even if we can successfully remove huge tumors, what are the 6 segments of the vertebral defect and how to protect the important structures and functions of the cervical spinal cord, the nerve root, the superior vertebral artery and so on?

In the face of difficulties before some future, director Xiao Jianru team several times in conjunction with the relevant expert system on the condition of the patient, determined by preoperative 3D precision 1:1 print cervical tumor model, the scope and boundary of accurate locking of huge chordoma. However, because of the large tumor and the wide range of the vertebral segment, the existing internal fixation instruments can not meet the need of reconstruction of the extra long segmental bone defect after surgical resection.

Xiao Jianru team carefully and comprehensively assess the condition, and fully communicate with patients and their families, frankly said: "we should jointly accept the challenge, together to fight for the last opportunity for the patient."."

In the light of many years' experience in clinical and medical engineering, Xiao Jianru has innovatively put forward an integrated system of 3D printing plates". "We use a computer 3D three-dimensional printing technology, on the basis of patients with CT and MRI imaging data, designs and patients with 6 vertebrae morphology and length of similar vertebral prosthesis, and repeatedly through the test simulation of dynamic mechanics, the final print out individual" 3D-6 vertebral plate integrated system "- the world's first 3D print 6 titanium alloy vertebral plate integrated prosthetic implants, will be completed up to 15 cm long span support in Zhou cervicothoracic, to replace the 6 vertebrae was completely removed.

Fully cooperate with the Department of Anesthesiology, Xiao Jianru, Yang Xinghai and Professor Zhao Jian team has two successful implementation of the anterior and posterior surgery, after 12 hours of fighting, successfully crossed the area of life, under the magnifying glass to the complete removal of the over 6 vertebral giant notochordal tumor at the same time, the successful implementation of the 3D print 6 titanium alloy vertebral plate integrated false body reconstruction, re opened the window of life! The symptoms of the patients were improved after surgery, no complications occurred recently discharged to a rehabilitation hospital to continue treatment.

According to Professor Xiao Jianru, individualized 3D printing plate integrated system the surgery compared with the previous artificial vertebral body, firstly the system not only has a spongy porous structure, the artificial trabecular structure to adjacent vertebral bone ingrowth into normal cells, and ultimately achieve bone fusion, but also effectively avoid the short board bone graft material is insufficient; secondly, the design according to the physiological curvature of the individual fixed, accurate matching, notch small, at the same time the system has multiple point contact surface, not easy to sink; furthermore, the system uses "three dimensional fixed mode, in addition to a pair of upper and lower vertebral transverse screw fixed, also more than one oblique endplate screw fixation, biomechanics has more excellent stability, overcomes the disadvantages of the artificial vertebral body of anti pull, anti rotation ability, Better support and stability. The new implant is currently available free of charge and approved by the hospital ethics committee.

The successful implementation of this operation marks the individualized 3D printing of the cervical vertebrae in our country, and the artificial vertebral body has entered the era of integration of plates, while we are in the forefront of the development of the integrated system of 3D printing plates. As technology and technology optimize and improve, this technology will benefit more patients.

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