title: Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result.
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.
authors.affiliation: Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Doyoung
authors.initials: D
authors.lastname: Kim
authors.affiliation: Department of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Korea.|Medyssey Co., Ltd., Uijeongbu, Korea.
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Lim
authors.affiliation: Department of Pediatric Neurosurgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyu Won
authors.initials: KW
authors.lastname: Shim
authors.affiliation: Department of Pediatric Hemato-Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung Woo
authors.initials: JW
authors.lastname: Han
authors.affiliation: Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seong
authors.initials: S
authors.lastname: Yi
authors.affiliation: Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Do Heum
authors.initials: DH
authors.lastname: Yoon
authors.affiliation: Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Keung Nyun
authors.initials: KN
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yoon
authors.initials: Y
authors.lastname: Ha
authors.affiliation: Department of Neurosurgery, Guro Cham Teun Teun Hospital, Seoul, Korea.
authors.forename: Gyu Yeul
authors.initials: GY
authors.lastname: Ji
authors.affiliation: Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea. cistern@yuhs.ac.
authors.forename: Dong Ah
authors.initials: DA
authors.lastname: Shin
mesh_terms: D001859:Bone Neoplasms / Q000601:surgery*; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000601:surgery*; D010388:Pelvis; D066330:Printing, Three-Dimensional; D019651:Plastic Surgery Procedures / Q000379:methods; D012447:Sacrum / Q000601:surgery*; D013997:Time Factors
keywords: 3D-printing; instrumentation; sacrum; spinal fusion