Abstract
The combination of 3D printing and navigation promises improvements in surgical procedures and outcomes for complex bone tumor resection of the trunk, but its features have rarely been described in the literature. Five patients with trunk tumors were surgically treated in our institution using a combination of 3D printing and navigation. The main process includes segmentation, virtual modeling and build preparation, as well as quality assessment. Tumor resection was performed with navigated instruments. Preoperative planning supported clear margin multiplanar resections with intraoperatively adaptable real-time visualization of navigated instruments. The follow-up ranged from 2–15 months with a good functional result. The present results and the review of the current literature reflect the trend and the diverse applications of 3D printing in the medical field. 3D printing at hospital sites is often not standardized, but regulatory aspects may serve as disincentives. However, 3D printing has an increasing impact on precision medicine, and we are convinced that our process represents a valuable contribution in the context of patient-centered individual care.
Highlights
All surgeries were conducted as conventional operations, except the osteotomies and the speed burring, for which the navigation system was used
Case 1 involved a 22-year-old female patient suffering from a multiple cartilaginous exostosis disease with a secondary peripheral chondrosarcoma G3 of the right ilium without metastasis
The resection was performed as navigated internal hemipelvectomy (P1a), followed by augmentation of the right ileum with a standard screw-rod system (Expedium, DePuy Synthes Spine Inc., Raynham, MA, USA) and revision cement
Summary
Bone tumors are rare and account for less than 0.2% of primary malignant neoplasms registered in the database for the European Cancer Registry-based study on the survival and care of cancer patients (EUROCARE) [1]. The classification system for surgical treatment of malignant bone and soft tissue tumors was defined by Enneking [2]. The main objective of surgical treatment is wide tumor resection with sufficient safety margins free of tumor cells [3]. Tumors close to the trunk, e.g., in the thorax/spine, sacrum and pelvis, involve highly challenging surgical resection techniques compared to tumors of the extremities. Critical aspects are acceptable postoperative function, the preservation of critical neurovascular structures and low perioperative morbidity, mortality and recurrence rates [4,5]. Functional limitations due to the loss of at least one hip joint component (P2)
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