J Shanghai Jiaotong Univ Sci

Journal of Shanghai Jiaotong University(Science) >

2021 , Vol. 26 >Issue 3: 325 - 333

DOI: https://doi.org/10.1007/s12204-021-2300-x

Medical 3D Printing and Personalised Medicine

Technique Note for Staged Resection of Giant Invasive High-Cervical Schwannoma and Reconstruction of  C2—C4 with 3D Printing Technique

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  • (a. Department of Orthopaedic Surgery; b. Department of Neurosurgery; c. Shanghai Key Laboratory of Orthopaedic
    Implants, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China)

Online published: 2021-06-02

Supported by

the National Key Research and Development
Program of China (No. 2017YFB1104104),
and the Special Foundation for Innovation of Science
and Technology of Shanghai Jiao Tong University
(Nos. GXQ201810 and GXQ202003)

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Abstract

A schwannoma is a relatively common benign spinal cord tumour; however, giant schwannomas with  extensive cervical vertebral erosion are rare, and the treatment strategy, especially the reconstruction of the upper  cervical vertebra, remains a challenge for spine surgeons. Here, we present a rare case of giant invasive highcervical  schwannoma with extensive erosion of the C2—C4 vertebral bodies and tumour-encased left vertebral  artery. The surgical strategy and the reconstruction of C2—C4 with 3D printing techniques were discussed and  performed. A 32-year-old man presented to our department with complaints of gait disturbance and weakness in  both upper and lower extremities. His limb muscle strength was grade 2 or 3/5, and he exhibited severe bladder  and bowel dysfunction on admission. X-ray and computed tomography of the cervical spine showed an extremely  large erosive lesion at the C2—C4 vertebral bodies and lateral masses. Magnetic resonance imaging of the cervical  spine showed a large soft-tissue mass on the left aspect of the C2—C5 vertebra and in the spinal canal at the  C3—C4 level. A staged schwannoma resection, instrumented fixation, and reconstruction of C2—C4 with 3D  metal printing technique were performed. The patient achieved good postoperative outcomes and returned to  normal daily life with no recurrence of schwannoma during follow-up for four and a half years. The 3D-printed  implant achieved solid fusion with the remaining cervical spine. We performed staged resection of the giant  invasive high-cervical schwannoma and reconstructed the erosive C2—C4 vertebra with the assistance of a 3D  printing technique. 3D printing technology has facilitated the design and manufacture of customised implants for  complex surgical procedures.

Cite this article

SUN Xiaojiang(孙晓江), ZHAO Changqing (赵长清), YANG Erzhu(杨二柱), LI Hua (李华), ZHANG Kai (张凯), CHENG Xiaofei(程晓非), JIANG Wenbo (姜闻博), CHENG Zhihua(程志华), GUO Zhilin (郭智霖), DAI Kerong (戴尅戎), ZHAO Jie (赵杰) . Technique Note for Staged Resection of Giant Invasive High-Cervical Schwannoma and Reconstruction of  C2—C4 with 3D Printing Technique[J]. Journal of Shanghai Jiaotong University(Science), 2021 , 26(3) : 325 -333 . DOI: 10.1007/s12204-021-2300-x

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