Experience of using personalized titanium vertebral corpectomy prosthesis for replacement of postresection defects in children with aggressive benign spinal tumors

Introduction. Aggressive benign spinal tumors in children frequently require extensive surgical resection necessitating complex reconstructive interventions. Currently, vertebrologists have at their disposal a large number of prostheses for replacement of the anterior supporting column. Both static implants and extendable spacer are used. However, these implants have limitations which can affect long-term results especially in children when growth should be taken into account and long-term stability of the prosthesis should be assured. Design of personalized titanium prostheses adapted to anatomical features of the vertebrae allows to solve these problems.

Aim. To evaluate the effectiveness of using personalized titanium vertebral corpectomy prostheses for reconstruction of postresection defects in children with aggressive benign spinal tumors (stage III per the Enneking classification).

Materials and methods. The study included 5 patients of pediatric age who underwent two-stage surgical intervention including dorsal stabilization, tumor resection and installation of a personalized titanium vertebral corpectomy prosthesis manufactured using direct metal laser sintering (DMLS) 3D printing.

Results. No significant complications were observed in the postoperative period. In the first 3 months, neurological status was completely restored in all patients. Computed tomography showed stable implant integration; minimal signs of prosthesis subsidence (1 mm without signs of resorption around screw implants) were observed only in 1 case.

Conclusion. The use of personalized titanium vertebral corpectomy prostheses improves the results of surgical treatment of spinal tumors in children. The proposed innovative technique of postresection defect replacement with personalized implants manufactured by 3D printing increases spinal fixation stability after extensive tumor resection and decreases the risk of complications associated with implant instability. The use of additive methods of prosthesis manufacturing allows to solve complex reconstruction problems in spinal surgical interventions in children.