A Novel Technology for 3D‐Printing Artificial Vertebral Bodies for Treating Lumbar Spine Adrenal Pheochromocytoma Metastases: A Case Report and Review of the Literature
Background Pheochromocytoma is an adrenal medullary neuroendocrine tumor that rarely metastasizes to the spine. Currently, its specific treatment methods still present challenges. Case Description A 41‐year‐old male patient who underwent left total adrenalectomy due to pheochromocytoma 3 years ago p...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-12-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13899 |
| _version_ | 1827596512434061312 |
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| author | Yadong Zhang Houkun Li Wentao Wang Lequn Shan Dingjun Hao |
| author_facet | Yadong Zhang Houkun Li Wentao Wang Lequn Shan Dingjun Hao |
| author_sort | Yadong Zhang |
| collection | DOAJ |
| description | Background Pheochromocytoma is an adrenal medullary neuroendocrine tumor that rarely metastasizes to the spine. Currently, its specific treatment methods still present challenges. Case Description A 41‐year‐old male patient who underwent left total adrenalectomy due to pheochromocytoma 3 years ago presented with lower back pain, accompanied by numbness and decreased muscle strength in both legs, as well as decreased sensation. Abnormal transmittance of the L3 vertebral body could be seen on anterior–posterior and lateral lumbar X‐rays, irregular bone destruction of the L3 vertebral body was found on CT, and an MRI scan showed that the tumor was located within the L3 vertebral body, protruding into the spinal canal and compressing the epidural sac. No recurrence was found in the abdomen. Preoperatively, perform local embolization of the blood vessels supplying the tumor. First, the L2‐3 intervertebral disc, L3‐4 intervertebral disc and L3 vertebral body were removed using an anterior approach, the whole tumor was removed, and some of the vertebrae were taken for pathological examination and replaced with a 3D‐printed prosthesis. Then, four pedicle screws were placed in the bilateral pedicles of L2 and L4 using the posterior approach, pre‐bent connecting rods were installed to replace the bone cortex of the lamina and articular process followed by bone graft fusion of the interlaminar and facet joints. The postoperative results were satisfactory, and there were no perioperative complications. Conclusion Lumbar pheochromocytoma metastasis is rare, difficult to treat, and should be considered in spinal metastases' differential diagnoses so early diagnosis can be made based on medical history and imaging. Preoperative local vascular imaging and embolization of the blood supply vessels were performed. After total en‐bloc spondylectomy of the tumor during surgery, a prosthesis was implanted and combined with pedicle screw fixation to reconstruct spinal biomechanical stability, achieving satisfactory results. Therefore, 3D printed artificial vertebral bodies are a good choice for treating adrenal pheochromocytoma lumbar metastasis. The key to successful treatment is close interdisciplinary collaboration in formulating rigorous comprehensive perioperative plans. |
| first_indexed | 2024-03-09T03:11:37Z |
| format | Article |
| id | doaj.art-13274dbaefd349f2ac0cd857353ce167 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-03-09T03:11:37Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-13274dbaefd349f2ac0cd857353ce1672023-12-04T02:35:49ZengWileyOrthopaedic Surgery1757-78531757-78612023-12-0115123335334110.1111/os.13899A Novel Technology for 3D‐Printing Artificial Vertebral Bodies for Treating Lumbar Spine Adrenal Pheochromocytoma Metastases: A Case Report and Review of the LiteratureYadong Zhang0Houkun Li1Wentao Wang2Lequn Shan3Dingjun Hao4Department of Spine Surgery, Honghui Hospital Xi'an Jiaotong University Xi'an ChinaDepartment of Spine Surgery, Honghui Hospital Xi'an Jiaotong University Xi'an ChinaDepartment of Spine Surgery, Honghui Hospital Xi'an Jiaotong University Xi'an ChinaDepartment of Spine Surgery, Honghui Hospital Xi'an Jiaotong University Xi'an ChinaDepartment of Spine Surgery, Honghui Hospital Xi'an Jiaotong University Xi'an ChinaBackground Pheochromocytoma is an adrenal medullary neuroendocrine tumor that rarely metastasizes to the spine. Currently, its specific treatment methods still present challenges. Case Description A 41‐year‐old male patient who underwent left total adrenalectomy due to pheochromocytoma 3 years ago presented with lower back pain, accompanied by numbness and decreased muscle strength in both legs, as well as decreased sensation. Abnormal transmittance of the L3 vertebral body could be seen on anterior–posterior and lateral lumbar X‐rays, irregular bone destruction of the L3 vertebral body was found on CT, and an MRI scan showed that the tumor was located within the L3 vertebral body, protruding into the spinal canal and compressing the epidural sac. No recurrence was found in the abdomen. Preoperatively, perform local embolization of the blood vessels supplying the tumor. First, the L2‐3 intervertebral disc, L3‐4 intervertebral disc and L3 vertebral body were removed using an anterior approach, the whole tumor was removed, and some of the vertebrae were taken for pathological examination and replaced with a 3D‐printed prosthesis. Then, four pedicle screws were placed in the bilateral pedicles of L2 and L4 using the posterior approach, pre‐bent connecting rods were installed to replace the bone cortex of the lamina and articular process followed by bone graft fusion of the interlaminar and facet joints. The postoperative results were satisfactory, and there were no perioperative complications. Conclusion Lumbar pheochromocytoma metastasis is rare, difficult to treat, and should be considered in spinal metastases' differential diagnoses so early diagnosis can be made based on medical history and imaging. Preoperative local vascular imaging and embolization of the blood supply vessels were performed. After total en‐bloc spondylectomy of the tumor during surgery, a prosthesis was implanted and combined with pedicle screw fixation to reconstruct spinal biomechanical stability, achieving satisfactory results. Therefore, 3D printed artificial vertebral bodies are a good choice for treating adrenal pheochromocytoma lumbar metastasis. The key to successful treatment is close interdisciplinary collaboration in formulating rigorous comprehensive perioperative plans.https://doi.org/10.1111/os.138993D‐printed artificial vertebral bodyPheochromocytomaSpinal metastasisTotal en‐bloc spondylectomyTreatment strategy |
| spellingShingle | Yadong Zhang Houkun Li Wentao Wang Lequn Shan Dingjun Hao A Novel Technology for 3D‐Printing Artificial Vertebral Bodies for Treating Lumbar Spine Adrenal Pheochromocytoma Metastases: A Case Report and Review of the Literature Orthopaedic Surgery 3D‐printed artificial vertebral body Pheochromocytoma Spinal metastasis Total en‐bloc spondylectomy Treatment strategy |
| title | A Novel Technology for 3D‐Printing Artificial Vertebral Bodies for Treating Lumbar Spine Adrenal Pheochromocytoma Metastases: A Case Report and Review of the Literature |
| title_full | A Novel Technology for 3D‐Printing Artificial Vertebral Bodies for Treating Lumbar Spine Adrenal Pheochromocytoma Metastases: A Case Report and Review of the Literature |
| title_fullStr | A Novel Technology for 3D‐Printing Artificial Vertebral Bodies for Treating Lumbar Spine Adrenal Pheochromocytoma Metastases: A Case Report and Review of the Literature |
| title_full_unstemmed | A Novel Technology for 3D‐Printing Artificial Vertebral Bodies for Treating Lumbar Spine Adrenal Pheochromocytoma Metastases: A Case Report and Review of the Literature |
| title_short | A Novel Technology for 3D‐Printing Artificial Vertebral Bodies for Treating Lumbar Spine Adrenal Pheochromocytoma Metastases: A Case Report and Review of the Literature |
| title_sort | novel technology for 3d printing artificial vertebral bodies for treating lumbar spine adrenal pheochromocytoma metastases a case report and review of the literature |
| topic | 3D‐printed artificial vertebral body Pheochromocytoma Spinal metastasis Total en‐bloc spondylectomy Treatment strategy |
| url | https://doi.org/10.1111/os.13899 |
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