Reconstruction with a 3D-printed Prosthesis and Internal Fixation with Novel Four-Rod Technique After En Bloc Resection of Meningiomas in the Lumbosacral Region (L5-S3) without Rectum/Bladder Function Sacrifice: Technical Case Report
Liwei PENG1,Peng WANG1,Wei JIANG1,Chao CHENG1,Wei ZUO1,Yan QU1,Weixin LI1
1Fourth Military Medical University, Tangdu Hospital, Department of Neurosurgery, Xi?an, People?s Republic of China
DOI :
10.5137/1019-5149.JTN.28031-19.2
Spinal meningiomas are rare in the lumbosacral region. The best solution is complete tumor resection. However, how to preserve the
patient?s rectum/bladder function after en bloc resection is still a considerable challenge, even without spinopelvic reconstruction.
The use of the three-dimensional (3D) printing technique may simplify it. The final step after restoration is the establishment of rigid
fixation. The purpose of this article was to present a case of lumbosacral meningiomas treated by en bloc resection, 3D-printed
prosthesis reconstruction, and fixation with pedicle screws and cortical bone trajectory screws.
A 35-year-old woman has suffered from lumbosacral and two legs pain for two months. During the previous month, she limped,
and her strength was 4/5 in both legs. Magnetic resonance imaging (MRI) revealed space-occupying lesions from the lumbar 5 (L5)
to sacral 3 (S3) vertebral bodies. The previous biopsy confirmed the lesions were spinal meningiomas. The patient underwent an
en bloc resection followed by 3D-printed prosthesis reconstruction and internal fixation with a novel technique. The surgery was
successful, and the patient recovered well postoperatively according to follow-up examination.
En bloc resection of L5-S3 meningiomas without rectum/bladder function sacrifice is a feasible procedure, and 3D-printed prosthesis
provides an alternative method for the reconstruction of the spinopelvic ring. The rigid fixation construct using the novel four-rod
technique could develop strong bony fusion.
Keywords :
En bloc, Four-rod technique, Rectum/bladder function, Spinal meningioma, 3D-printed prosthesis