Aug 29, 2016 | By Tess

A team of doctors from China’s Shanghai Changzheng Hospital have successfully implanted a 15 centimeter long 3D printed titanium vertebrae prosthetic into a patient suffering from a serious case of cervical chordoma. The patient, 40-year-old Ms. Zhou from HuNan province, had been suffering from the debilitating disease for nearly 7 years and had just about given up on life until 3D printing presented an almost miraculous treatment option.

During the course of her disease, Ms. Zhou underwent a number of surgeries which proved ultimately unsuccessful, as the tumor located on her upper spinal cord and neck kept returning. The malignant tumor itself, which had grown to envelop the length of six vertebrae, was causing a number of problems, including severe compression of the trachea and esophagus, which made breathing and eating two very difficult tasks for the patient.

As one can imagine, this made life very difficult for Ms. Zhou, but the patient, inspired by her family, was not ready to give up. After reaching out to a number of hospitals and clinics around China and finding that many of them could not help her because of the complexity of the disease and its treatment, the patient’s case finally got picked up by a team from the Shanghai Changzheng Hospital.

The team, led by one Professor Xiao Jianru, investigated Ms. Zhou’s condition and found a potential, though still risky solution as her condition was indeed complex. Specifically, after conducting a number of magnetic resonance examinations, the doctors found that Ms. Zhou’s tumor had grown to be wrapped around her vertebrae section 3-7, her thoracic section 1, and on both sides of her carotid and vertebral arteries. Additionally, because one side of her vertebral arteries had already been blocked as a result of one of her first surgeries, the blockage of the remaining side caused by the tumor was becoming increasingly critical and presented a number of challenges for the doctors and their surgical plans.

For instance, if any additional damage was caused to the vertebral artery during the procedure, there could be a shortage of blood supply to the brain, which could even be fatal. Even in the case of a successful removal of the tumor from the vertebrae, traditional cervical vertebra plates and titanium meshes would not be sufficient for supporting and protecting the spinal cord, nerve roots, and other surrounding parts.

To meet these challenges, the team of doctors spent a long time discussing possible treatment options and finally settled on using an anatomically correct 1:1 3D printed cervical tumor model to use as a preoperative device. This 3D printed model allowed them to visualize and plan out their next steps, which also included the designing and manufacturing of a 3D printed plate integrated system.

As Professor Xiao Jianru explained, “We used 3D imaging and 3D printing technology based on the patient’s CT and MRI imaging data and designed a spinal prosthesis which is similar to the shape and length of the patient’s spinal section.” After many mechanical and simulation tests, the team was able to 3D print a 6 vertebrae plate integrated system, which is being heralded as the world’s first of its kind. The novel system was to be implanted in Ms. Zhou and act as a 15cm long support on her cervical and thoracic vertebra by completely replacing the defected 6 section of her spine.

The 3D printed implant was also designed to incorporate a sponge-like porous structure meant to promote the natural growth of bone cells and ultimately result in bone fusion in the patient for optimal recovery and strength. Additionally, the implant system also has a three-point perspective fixed mode in addition to a pair of lateral vertebral screw fixation devices which adds additional biomechanical stability. According to the doctors, the implant's design overcomes the current artificial vertebral anti-pull and anti-rotation and helps to achieve all around better support and stability.

The surgery itself took a gruelling 12 hours, but resulted in a successful implantation of the 3D printed vertebrae. According to the doctors, the patient’s symptoms have been improving since the surgery and no related complications have occurred. Since the surgery, Ms. Zhou has been discharged from the hospital and is now in the care of a rehabilitation hospital to continue her treatment.

Posted in 3D Printing Application

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