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Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result

Authors
 Doyoung Kim  ;  Jun-Young Lim  ;  Kyu-Won Shim  ;  Jung Woo Han  ;  Seong Yi  ;  Do Heum Yoon  ;  Keung Nyun Kim  ;  Yoon Ha  ;  Gyu Yeul Ji  ;  Dong Ah Shin 
Citation
 Yonsei Medical Journal, Vol.58(2) : 453-457, 2017 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2017
MeSH
Bone Neoplasms/surgery* ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteosarcoma/surgery* ; Pelvis ; Printing, Three-Dimensional* ; Reconstructive Surgical Procedures/methods ; Sacrum/surgery* ; Time Factors
Keywords
3D-printing ; instrumentation ; sacrum ; spinal fusion
Abstract
Pelvic reconstruction after sacral resection is challenging in terms of anatomical complexity, excessive loadbearing, and wide defects. Nevertheless, the technological development of 3D-printed implants enables us to overcome these difficulties. Here, we present a case of sacral osteosarcoma surgically treated with hemisacrectomy and sacral reconstruction using a 3D-printed implant. The implant was printed as a customized titanium prosthesis from a 3D real-sized reconstruction of a patient's CT images. It consisted mostly of a porous mesh and incorporated a dense strut. After 3-months of neoadjuvant chemotherapy, the patient underwent hemisacretomy with preservation of contralateral sacral nerves. The implant was anatomically installed on the defect and fixed with a screw-rod system up to the level of L3. Postoperative pain was significantly low and the patient recovered sufficiently to walk as early as 2 weeks postoperatively. The patient showed left-side foot drop only, without loss of sphincter function. In 1-year follow-up CT, excellent bony fusion was noticed. To our knowledge, this is the first report of a case of hemisacral reconstruction using a custom-made 3D-printed implant. We believe that this technique can be applied to spinal reconstructions after a partial or complete spondylectomy in a wide variety of spinal diseases.
Files in This Item:
T201700693.pdf Download
DOI
10.3349/ymj.2017.58.2.453
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
김긍년(Kim, Keung Nyun)
김도영(Kim, Do Young)
신동아(Shin, Dong Ah) ORCID logo https://orcid.org/0000-0002-5225-4083
심규원(Shim, Kyu Won) ORCID logo https://orcid.org/0000-0002-9441-7354
윤도흠(Yoon, Do Heum) ORCID logo https://orcid.org/0000-0003-1452-5724
이성(Yi, Seong)
하윤(Ha, Yoon)
한정우(Han, Jung Woo) ORCID logo https://orcid.org/0000-0001-8936-1205
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154531
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