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  

Clinical observation on the application of customized 3D printed prosthetic body weight in the treatment of axial tumors

作　　者：菅强 许文龙 段婉茹[1] 刘振磊 关健 张璨[1] 菅凤增[1] 陈赞[1] JIAN Qiang;XU Wenlong;DUAN Wanru(Neurosurgery Department,Xuanwu Hospital,Capital Medical University,Beijing,100053,China;不详)

机构地区：[1]首都医科大学宣武医院神经外科,北京市100053

出　　处：《中国脊柱脊髓杂志》2020年第9期804-810,共7页Chinese Journal of Spine and Spinal Cord

基　　金：首发自主创新(编号:2018-2-2014)。

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。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.

关 键 词：枢椎 3D打印 上颈椎肿瘤 

分 类 号：R738.1[医药卫生—肿瘤] R318.1[医药卫生—临床医学]