3D-printed Titanium Prosthetic Reconstruction of the C2 Vertebra: Techniques and Outcomes of Three Consecutive Cases.

Abstract

Three patients were treated at our center with patient-specific three-dimensional (3D)-printed titanium prostheses for the reconstruction of structurally compromised C2 vertebrae. To describe our surgical and device design approach to these clinical scenarios and evaluate their outcomes. There are a limited but increasing number of case reports and series describing the use of 3D-printed prostheses for high cervical surgery. We have collated and reviewed three cases using patient-specific 3D-printed prostheses. We report two cases arising from neoplastic destruction; one resulting from metastatic medullary thyroid carcinoma, and the other from multiple myeloma. We additionally describe a case of C2 compromise as a complication of rheumatoid arthritis. All patients included in this report achieved successful surgical outcomes and symptom relief without significant complication. Clinical and radiological follow-up has demonstrated good outcomes in all cases up to 14-months postprocedure. These cases describe successful use of custom 3D-printed prostheses for reconstruction of the anterior vertebral column through C2, and add to the emerging body of literature detailing the use of custom prostheses for complex spinal surgery. 4.