Turkish Neurosurgery
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 Wang 1, Wei Jiang1, Chao Cheng1, Wei Zuo1, Yan Qu1, Weixin Li1
1Tangdu Hospital, Fourth Military Medical University, Department of Neurosurgery, Xi\'an,
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 big challenge, let alone spinopelvic reconstruction. The application of the three-dimensional (3D) printing technique may simplify it. After restoration, to form a more rigid fixation is the last procedure. The purpose of this article is 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 past month, she limped, and her strength was 4/5 in both legs. The magnetic resonance imaging (MRI) results revealed space-occupying lesions from 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 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. Besides, the rigid fixation construct using the novel four-rod technique could develop strong bony fusion.

Corresponding author : Weixin Li