The Total En Bloc Spondylectomy Hybridization Surgery and its 3D-Printed Applications: A Review

Abstract

As the incidence of spinal tumors increases, so too does the demand for modern surgical solutions. Spinal tumors may begin as either metastatic or primary, but in both cases can develop rapidly causing a compression in the cauda equina nerve or spinal cord. Such compression causes neurological dysfunction, resulting in both tremendous pain and spinal instability. A key emerging surgical method in the removal of spinal tumors is the total en bloc spondylectomy (TES), a development of the previously popular en bloc spondylectomy. Since its development in 1989, the demanding and sophisticated surgical intervention has been gaining popularity and has now become accepted by musculoskeletal and tumor surgeons. The total en bloc spondylectomy serves as an effective approach in entirely removing the tissue which is damaged whilst not interfering with the spine’s integrity. This procedure is done by various methods, all of which involve the careful reconstruction of the spine stability. In modern times, this surgery has been conducted in a hybridization format utilizing 3D-printers. This paper will delve into the four major 3D-printed components allowing for spinal reconstruction, artificial vertebral bodies, titanium cages, pedicle screws and rods, and guides. Similarities, differences, problems and more will be compared and contrasted whilst carefully examining the various printing methods, the biomaterials and each of their unique surgical applications.