anterior_column_reconstruction [Neurosurgery Wiki]

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Various techniques for [[anterior column]] reconstruction have been described after [[en bloc resection]] of [[spinal tumor]]s. Limited evidence exists regarding one being superior to another. The purpose of a study was to evaluate 3D-printed vertebral bodies for spinal reconstruction after en bloc resection in the [[thoracolumbar spine]].

Prospective observational study on custom-made 3D-printed titanium reconstruction of vertebral bodies after en bloc resection for spinal tumor was conducted between November 2015 and June 2017. 3D-printed vertebral bodies were monitored for mechanical complications such as (1) [[migration]], (2) [[subsidence]] into the adjacent vertebral bodies, and/or (3) breakage. Complications and related details were recorded.

Thirteen patients (7 females and 6 males) were enrolled, and reconstruction of the anterior column was performed using custom-made 3D-printed [[titanium]] [[prosthesis]] after en bloc resection for [[spinal tumor]] (8 primary [[bone tumor]]s and 5 solitary [[metastases]]). Subsidence into the adjacent vertebral bodies occurred in all patients at both proximal and distal bone-implant interfaces; however, it was clinically irrelevant (asymptomatic, and no consequences on posterior instrumentation), in 11 out of 12 patients (92%). In 1 patient, severity of the subsidence led to revision of the construct. At an average 10-month follow-up (range 2-16), 1 implant was removed due to local recurrence of the disease and 1 was revisioned due to progressive distal junctional kyphosis.

Preliminary results from this series suggest that 3D printing can be effectively used to produce custom-made prosthesis for anterior column reconstruction
((Girolami M, Boriani S, Bandiera S, Barbanti-Bródano G, Ghermandi R, Terzi S,
Tedesco G, Evangelisti G, Pipola V, Gasbarrini A. Biomimetic 3D-printed
custom-made prosthesis for anterior column reconstruction in the thoracolumbar
spine: a tailored option following en bloc resection for spinal tumors :
Preliminary results on a case-series of 13 patients. Eur Spine J. 2018
Dec;27(12):3073-3083. doi: 10.1007/s00586-018-5708-8. Epub 2018 Jul 23. PubMed
PMID: 30039254.
)).
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Smith ZA, Wong AP, El Ahmadieh TY, Aoun SG, Haque R, Bendok BB, Fessler RG. 
Minimally invasive thoracic corpectomy: 3-dimensional operative video of a
posterolateral approach to decompression and [[anterior column reconstruction]].
Neurosurgery. 2013 Dec;73(2 Suppl Operative):ons141. doi:
10.1227/01.neu.0000431467.97462.e1. PubMed PMID: 23719053.