The cervical spine is covered by a huge tumor of the 6 vertebrae, and along the lateral cervical spine, "Climbing" into several segments of transverse process, small joint, spinal canal and spinal canal, the large blood vessels, the common carotid artery, severe compression of spinal cord, trachea, esophagus...... Even more difficult is that the existing cervical titanium mesh and titanium plate internal fixation device can not meet the reconstruction of long segment defect after tumor resection. Recently,; the Second Military Medical University; Shanghai Changzheng Hospital bone tumor surgery (long spinal tumor center) after professor of research and development team designed the world's first 3D printing titanium alloy 6 vertebral plate integrative prosthesis, used in cervical and thoracic long segmental giant chordoma resection after defect reconstruction success, breaking the world's longest cervical tumor vertebral resection and reconstruction of the record.
Giant tumor is wrapped around the 6 segment of the cervical spine.
From Hunan 40 weeks lady suffering from cervical chordoma for up to 7 years old, during which experienced a recurrence reoperation after recent unfortunate recurrence. With the growing increase in the neck tumor, severe oppression of the trachea and esophagus, breathing and eating women have become a problem, and even the daily operation of the chopsticks and other daily actions are increasingly difficult. This is an aggressive malignant tumor, high recurrence rate, good hair in the occipital cervical and sacrum.
Years of pain and torture let Ms. Zhou repeatedly wants to finish the rest of your life, think of with old the oldest parents, under a starving daughter, during which she dragged a causative agent traveled all over the national large and small hospitals, are due to the complex condition, operation difficulty big was declined. Finally, she attracted experts at the recommendation of the director Xiao Jianru came to Shanghai to find a bone tumor surgery, Changzheng hospital.
The NMR magnetic inspection showed that Ms. Zhou suffer from chordoma has eroded section 3-7 of the cervical and thoracic section 1, is more serious, the giant tumors will be on both sides of the vertebral artery and in front of the common carotid artery, external carotid artery and internal jugular vein wrapped tightly around. Also due to the initial surgery of unilateral vertebral artery is ligated occlusion and tumor around the other side of the vertebral artery dominance is crucial for the blood supply to the brain, reoperation once the damage will lead to a serious shortage of blood supply to the brain stem life-threatening. For this rare and difficult cases, and cervical spine anatomy structure compared to the thoracic and lumbar spine is more complex, operation difficulty can be imagined. Even if the huge tumor can be removed successfully, what is the support of the 6 segment of the vertebral segment defect, how to protect the cervical spinal cord, nerve root, superior vertebral artery and other important structures and functions?
15 cm cervical implants hold up the backbone"
Face before some future difficulties, after director team repeatedly in conjunction with the relevant expert system studied the condition of the patient, decided by preoperative 3D accurate 1:1 print cervical tumor model, accurate lock the scope and boundaries of giant chordoma. However, due to the large tumor, the wide range of the vertebral segment, the existing internal fixation devices can not meet the surgical resection of long bone defect reconstruction. Xiao Jianru team carefully comprehensive assessment of the disease and full communication with patients and their families, frankly: we should jointly accept the challenge, to fight for the last chance of a patient."
Xiao Jianru combined with many years of clinical and "medical" experience, innovative proposed "3D printing plate body integration system". "We use computer 3D printing technology, according to the patient's CT and MRI imaging science data, design is similar to that of patients with 6 vertebral morphology and length of spinal prosthesis, and repeatedly through dynamic simulation test, final print out individual" 3D-6 vertebral plate body of various system "- the world's first 3D printing titanium alloy 6 vertebral plate integrated prosthesis implant, in Ms. Zhou of the cervical and thoracic completed up to 15 cm long span support as an alternative to be excised completely 6 vertebrae.
Under the full cooperation of Anesthesiology, Xiao, Yang Xinghai, Zhao Jian, a professor of the formation of team has two successful implementation of the anterior and posterior surgery, after 12 hours of fighting, success beyond the area of life, under the magnifying glass to complete removal of the across six vertebral giant notochordal tumor at the same time, the successful implementation of the 3D printing titanium alloy 6 vertebral plate integration of false body reconstruction, re opened the window of the life. After the operation, the patient's symptoms improved significantly, and no related complications, recently, have been successfully discharged to the hospital to continue treatment.
According to Professor Xiao Jianru, individualized 3D printing plate integrated system the surgery compared with the previous artificial vertebral body, firstly the system not only has a spongy porous structure, the artificial trabecular structure to adjacent vertebral bone ingrowth into normal cells, and ultimately achieve bone fusion, but also effectively avoid the short board bone graft material is insufficient; secondly, the design according to the physiological curvature of the individual fixed, accurate matching, notch small, at the same time the system has multiple point contact surface, not easy to sink; furthermore, the system uses "three dimensional fixed mode, in addition to a pair of upper and lower vertebral transverse screw fixed, also more than one oblique endplate screw fixation, biomechanics has more excellent stability, overcomes the disadvantages of the artificial vertebral body of anti pull, anti rotation ability , better to achieve the purpose of support and stability.
According to reports, this new implant is currently free of charge, and access to the hospital ethics committee approved the use of. The successful implementation of the surgery marks the Chinese cervical spine individual 3D printing artificial vertebral body into the era of integration of the plate body, with the optimization of technology and process improvement, this technology will allow more patients to benefit.