3.8 Article

Thoracic wall reconstruction using a 3D-printed prosthesis with hinged fixation to the vertebral column: A case report and technical note

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DOI: 10.1016/j.inat.2023.101867

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Thoracic wall and spine tumor; Resection and reconstruction; Surgical technique; Three-dimensional printing; Hinged articulating prosthesis; Pulmonary function

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This case report describes a successful surgical approach for a patient with a pleural based mass, using en bloc tumor resection and a 3D printed prosthesis to repair the chest wall defect, resulting in preserved pulmonary mechanics.
Background: Malignant tumors can arise from the thoracic wall and vertebral column. Complete tumor resection improves patient survival but remains technically challenging. An ideal surgical approach aims to establish appropriate tissue margins, address thoracic wall defects, and preserve pulmonary mechanics. Case presentation: A 54-year-old man was diagnosed with a large pleural based mass arising from the left hemithorax (5th to 10th ribs) with extension into the posterior paraspinal region (T6 to T9). En bloc tumor resection was performed followed by a chest wall defect reconstruction using a 3D printed prosthesis attached laterally to the residual ribs and medially to the inserted spinal instrumentation via a mobile articulation. No post-operative complications or respiratory sequela were noted at 18-month follow up. Conclusion: Utilizing a 3D-printed prosthesis articulating with spinal instrumentation to repair the composite defect of the chest wall can maintain normal breathing mechanics.

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