Efficacy and safety of 3D-printed artificial vertebral bodies for spinal tumor resection and reconstruction: a systematic review and meta-analysis.

Abstract

<h4>Objective</h4>To investigate the efficacy and safety of 3D printed artificial vertebral body in spinal reconstruction after total en bloc spondylectomy (TES) for spinal tumors.<h4>Methods</h4>We searched PubMed, Embase, ScienceDirect, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Database, and Wei Pu Database by computer to collect controlled clinical studies on the efficacy and safety of 3D printed artificial vertebral body and titanium mesh cages (TMCs) in the treatment of spinal tumors after total en bloc spondylectomy (TES) from database establishment to February 2024.<h4>Results</h4>A total of 10 cohort studies and 2 randomized controlled study with a total of 489 patients were included in this study, including 234 patients in the 3D group and 255 patients in the TMC group. The 3D group had lower intraoperative blood loss than the TMC group [mean difference (MD) = - 1.47, 95% CI (- 2.38, -0.55), P = 0.002] and operation time was shorter than that of the TMC group [MD = -0.65, 95% CI (- 1.23, - 0.07), P = 0.03]. Early postoperative JOA scores improved more significantly in the TMC group [MD = 0.50, 95% CI (0.18, 0.82), P = 0.002].<h4>Conclusion</h4>The 3D printing group demonstrated advantages in early postoperative pain relief (VAS) and spinal sequence maintenance (loss of Cobb angle), while there were no statistically significant differences between the two groups in Frankel grading and neurological improvement rates. Notably, the traditional titanium mesh group showed more significant improvements in early postoperative JOA scores.