Biomechanical and clinical evaluation of 3D-printed personalized vertebral implants after total En-Bloc spondylectomy: two-year follow-up outcomes.

Background: This prospective study evaluated the efficacy of 3D-printed personalized vertebral implants in restoring spinal stability following total en bloc spondylectomy (TES) for benign spinal tumors. Given the lack of specialized implants for post-resection reconstruction, this approach integrates customized 3D-printed implants to enhance the anatomical precision, biomechanical stability, and clinical outcomes.

Methods: Four patients underwent TES using custom-designed 3D-printed vertebral implants. Key surgical parameters including operative time, intraoperative blood loss, pain reduction (VAS), and functional recovery (ODI) were assessed. Biomechanical testing was conducted to evaluate implant durability under high loads. Functional and neurological outcomes were monitored over a two-year follow-up period using clinical assessments and CT imaging.

Results: Personalized 3D-printed implants demonstrated high mechanical stability with no structural deformation under load-bearing conditions. Postoperative VAS and ODI scores significantly improved, indicating substantial pain reduction and enhanced functional recovery. Neurological evaluations revealed that 75% of patients regained full motor and sensory functions. CT imaging confirmed stable implant positioning, with no signs of subsidence, fixation failure, or implant-related complications.

Conclusions: This study highlights the clinical feasibility and potential advantages of 3D-printed personalized vertebral implants for spinal reconstruction, including optimized surgical planning, reduced operative time, and minimal blood loss. Despite promising short-term outcomes, further large-scale, multicenter trials are required to establish long-term clinical efficacy and broader applicability in diverse patient populations.