Journal of Veterinary Science

The Korean Society of Veterinary Science (대한수의학회)
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Cervical spine reconstruction after total vertebrectomy using customized three-dimensional-printed implants in dogs

  • Ji-Won Jeon (Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Kyu-Won Kang (Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Woo-Keyoung Kim (Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Sook Yang (CUSMEDI Co., Ltd.) ;
  • Byung-Jae Kang (Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University)
  • Received : 2023.09.27
  • Accepted : 2023.11.28
  • Published : 2024.01.31
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Abstract

Background: Sufficient surgical resection is necessary for effective tumor control, but is usually limited for vertebral tumors, especially in the cervical spine in small animal neurosurgery. Objective: To evaluate the primary stability and safety of customized three-dimensional (3D)-printed implants for cervical spine reconstruction after total vertebrectomy. Methods: Customized guides and implants were designed based on computed tomography (CT) imaging of five beagle cadavers and were 3D-printed. They were used to reconstruct C5 after total vertebrectomy. Postoperative CT images were obtained to evaluate the safety and accuracy of screw positioning. After harvesting 10 vertebral specimens (C3-C7) from intact (group A) and implanted spines (group B), implant stability was analyzed using a 4-point bending test comparing with groups A and C (reconstituted with plate and pins/polymethylmethacrylate after testing in Group A). Results: All customized implants were applied without gross neurovascular damage. In addition, 90% of the screws were in a safe area, with 7.5% in grade 1 (< 1.3 mm) and 2.5% in grade 2 (> 1.3 mm). The mean entry point and angular deviations were 0.81 ± 0.43 mm and 6.50 ± 5.11°, respectively. Groups B and C significantly decreased the range of motion (ROM) in C3-C7 compared with intact spines (p = 0.033, and 0.018). Both groups reduced overall ROM and neutral zone in C4-C6, but only group B showed significance (p = 0.005, and 0.027). Conclusion: Customized 3D-printed implants could safely and accurately replace a cervical vertebra in dog cadavers while providing primary stability.

Keywords

Acknowledgement

We thank CUSMEDI Co., Ltd. for providing implants for this study.

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