Turkish Neurosurgery 2020 , Vol 30 , Num 4
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

Corresponding author : Weixin, tangdunaowai@163.com