Jingtao Ji

Study Design: The reconstruction of the anterior vertebral body using 3D-printed artificial vertebrae after total en bloc spondylectomy for spinal tumors restores spinal stability. Objective: To investigate the feasibility of using 3D-printed artificial vertebrae for spinal reconstruction after tumor resection. Summary of Background Data: Total en bloc spondylectomy is an effective surgical method for treating spinal tumors. However, reconstructing the vertebral body after tumor resection is challenging. 3D-printed artificial vertebrae offer a novel solution to this issue. Methods: From December 2016 to September 2023, 43 patients with malignant spinal tumors underwent vertebrectomy followed by reconstruction using 3D-printed artificial vertebrae. The cohort included 30 males and 13 females, aged 15–76 years, with a mean age of 58.0 years. Tumor types included 12 primary malignant tumors and 36 metastatic tumors. Clinical outcomes were assessed using preoperative and postoperative VAS scores at 24 hours and 3 months, Frankel grades, and radiologic evaluation of local tumor control and prosthesis subsidence. Results: Follow-up ranged from 3 to 31 months, with a mean of 10.9 months. There was a statistically significant improvement in VAS scores at 24 hours and 3 months postoperatively compared with preoperative scores ( P <0.01). Of the 43 patients, 42 (97.7%) showed at least one grade improvement in Frankel grade at the last follow-up. During the follow-up period, there were no cases of prosthesis subsidence among the patients who underwent reconstruction with 3D-printed artificial vertebrae. Conclusion: Porous titanium artificial vertebrae produced by 3D printing technology exhibit good biocompatibility and mechanical stability, making them suitable for reconstruction after vertebrectomy.

The upper cervical spine has a complex anatomical structure, making anterior surgical approaches challenging and prone to complications. This study aims to explore the use of bilateral submandibular incisions to provide safer and more convenient exposure of the upper cervical spine and to assess the feasibility of this approach for anterior surgical treatment of complex upper cervical diseases. From November 2019 to August 2021, three patients with malignant tumors of the upper cervical spine were subjected to an anterior–posterior combined approach for cervical tumor resection. The cohort consisted of one male and two females, aged between 41 and 51 years. The anterior approach began with a submandibular incision, followed by blunt dissection through the prevertebral muscles to expose the diseased vertebra. Subsequently, the diseased vertebra was excised, and either a titanium cage or a pre‐customized 3D‐printed artificial vertebral body was implanted anteriorly. Then, posterior fixation of the cervical spine was performed using pedicle screws to provide additional stability. Follow‐up ranged from 8 to 34 months. All patients experienced varying degrees of pain relief within 24 hours post‐operation. Frankel grading showed improvement by at least one grade in all three cases. Regular X‐ray and magnetic resonance imaging examinations revealed no tumor recurrence or involvement of adjacent vertebrae in the surgical area. The anterior bilateral submandibular horizontal incision approach offers comprehensive exposure of the anatomical structures of the upper cervical spine. This approach introduces a new option for the anterior treatment of upper cervical spine diseases.