<p>Application of Titanium Alloy 3D-Printed Artificial Vertebral Body for Stage III Kümmell’s Disease Complicated by Neurological Deficits</p>

Abstract

The current study aimed to compare the clinical and radiographic results of the 3D-printed artificial vertebral body (3DP-AVB) and titanium mesh cage (TMC) for the treatment of Kümmell's disease (KD) complicated by neurological deficits. Patients and Methods: From January 2014 to July 2018, 28 consecutive patients diagnosed with KD and nerve injuries in our department were treated by posterior vertebral column resection and internal fixation. The patients were divided into two groups (3DP-AVB group and TMC group) based on the different anterior column reconstruction implants. Clinical and radiographic parameters were used to evaluate the outcomes. Results: The two groups achieved excellent clinical and radiographic results 1 month after surgery with no significant difference (P>0.05), while 3DP-AVB group showed better outcomes compared with TMC group during the follow-up after 6 months (P<0.05). The risk of subsidence in 3DP-AVB group was lower than that in TMC group (41.6% vs 87.5%, P<0.05), and severe subsidence (≥5 mm) was correlated with the recurrence of back pain and bad daily life function. No significant difference was found in the improvement of neurological function between the two groups (P>0.05). The blood loss and operation time in 3DP-AVB group were significantly less than both in TMC group (P<0.05). Conclusion: The lower incidence of cage subsidence, with a better long-term efficacy in maintaining the height of the fused segment, relieving back pain, and improving daily life function indicates that the 3DP-AVB may be a superior alternative for KD with neurological deficits.

Comparison of clinical efficacy of 3D-printed artificial vertebral body and conventional titanium mesh cage in spinal reconstruction after total en bloc spondylectomy for spinal tumors: a systematic review and meta-analysis

“…The 3D-printed AVB was designed according to the location of the tumor and physiological curvature of the spine. The large contact area is conducive to the adhesion of bone tissue cells and provides good stability ( 37 ). Its three-dimensional microporous structure renders it high in strength and low in modulus, and it is less prone to the stress shielding effect.…”

Congenital Cervical Scoliosis Treated with Concave Side Distraction with Three‐Dimensional Printed Titanium Cage

“…In recent years, more and more studies have reported the application of customized 3D‐printed titanium alloy pore metal artificial vertebra, which gave us more options for cervical stability reconstruction 22–24 . Based on our experience, we designed a spacer for the concave facet joint and the anterior intervertebral space during preoperative planning.…”

“…In recent years, more and more studies have reported the application of customized 3D‐printed titanium alloy pore metal artificial vertebra, which gave us more options for cervical stability reconstruction. 22 , 23 , 24 Based on our experience, we designed a spacer for the concave facet joint and the anterior intervertebral space during preoperative planning. The rough surface of the spacer provided immediate stability and effectively reduced the stress borne by the screw, reducing the possibility of internal fixation failure.…”

3D printing metal implants in orthopedic surgery: Methods, applications and future prospects

“…Current spinal cages for interbody fusion procedures may lead to endplate fractures and collapse. Due to the particular usefulness of 3D printing in reconstructing complex geometries, they can be used in areas where current implants are not suitable to replace local anatomical structures [ 233 ]. In anterior cervical discectomy fusion (ACDF), 3D printing cages could significantly relieve symptoms, restore the curvature of the cervical spine, effectively maintain the intervertebral height for a long time, and prevent complications related to postoperative subsidence [ 234 ].…”