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Surgical guides (patient-specific instruments) for pediatric tibial bone sarcoma resection and allograft reconstruction

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Bellanova, Laura [UCL] Paul, Laurent [UCL] Docquier, Pierre-Louis [UCL]

To achieve local control of malignant pediatric bone tumors and to provide satisfactory oncological results, adequate resection margins are mandatory. The local recurrence rate is directly related to inappropriate excision margins. The present study describes a method for decreasing the resection margin width and ensuring that the margins are adequate. This method was developed in the tibia, which is a common site for the most frequent primary bone sarcomas in children. Magnetic resonance imaging (MRI) and computerized tomography (CT) were used for preoperative planning to define the cutting planes for the tumors: each tumor was segmented on MRI, and the volume of the tumor was coregistered with CT. After preoperative planning, a surgical guide (patient-specific instrument) that was fitted to a unique position on the tibia was manufactured by rapid prototyping. A second instrument was manufactured to adjust the bone allograft to fit the resection gap accurately. Pathologic evaluation of the resected specimens showed tumor-free resection margins in all four cases. The technologies described in this paper may improve the surgical accuracy and patient safety in surgical oncology. In addition, these techniques may decrease operating time and allow for reconstruction with a well-matched allograft to obtain stable osteosynthesis.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2013
Language Anglais
Journal information "Sarcoma" - Vol. 2013, no. Article ID 787653, p. [1-7] (2013)
Peer reviewed yes
Publisher Hindawi Publishing ((Egypt) Cairo)
issn 1357-714X
e-issn 1369-1643
Publication status Publié
Affiliations UCL - SSS/IREC/CARS - Computer Assisted Robotic Surgery
UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur
Links
  1. Bielack S., Kempf-Bielack B., Schwenzer D., Birkfellner T., Delling G., Ewerbeck V., Exner G., Fuchs N., Göbel U., Graf N., Heise U., Helmke K., Hochstetter A.R., Jürgens H., Maas R., Münchow N., Salzer-Kuntschik M., Treuner J., Veltmann U., Werner M., Winkelmann W., Zoubek A., Kotz R., Neoadjuvante Therapie des lokalisierten Osteosarkoms der Extremitäten, 10.1055/s-2007-1019701
  2. Paulussen M., Ahrens S., Dunst J., Winkelmann W., Exner G.U., Kotz R., Amann G., Dockhorn-Dworniczak B., Harms D., Müller-Weihrich S., Welte K., Kornhuber B., Janka-Schaub G., Göbel U., Treuner J., Voûte P.A., Zoubek A., Gadner H., Jürgens H., Localized Ewing Tumor of Bone: Final Results of the Cooperative Ewing’s Sarcoma Study CESS 86, 10.1200/jco.2001.19.6.1818
  3. Grimer Robert J, Surgical options for children with osteosarcoma, 10.1016/s1470-2045(05)01734-1
  4. MUSCOLO D. LUIS, AYERZA MIGUEL A., APONTE-TINAO LUIS A., RANALLETTA MAXIMILIANO, Use of Distal Femoral Osteoarticular Allografts in Limb Salvage Surgery : Surgical Technique, 10.2106/00004623-200609001-00014
  5. Choong Peter F.M., Sim Franklin H., Limb-sparing surgery for bone tumors: New developments, 10.1002/(sici)1098-2388(199701/02)13:1<64::aid-ssu10>3.0.co;2-9
  6. Clinical Orthopaedics and Related Research, 232 (2004)
  7. Muscolo D. Luis, Ayerza Miguel A., Aponte-Tinao Luis A., Massive Allograft Use in Orthopedic Oncology, 10.1016/j.ocl.2005.08.003
  8. Clinical Orthopaedics and Related Research, 181 (1991)
  9. Clinical Orthopaedics and Related Research, 116 (1994)
  10. Clinical Orthopaedics and Related Research, 186 (2000)
  11. Alman B A, De Bari A, Krajbich J I, Massive allografts in the treatment of osteosarcoma and Ewing sarcoma in children and adolescents. : , 10.2106/00004623-199501000-00008
  12. Clinical Orthopaedics and Related Research, 62 (1988)
  13. Clinical Orthopaedics and Related Research, 28 (1998)
  14. Studies in Health Technology and Informatics, 88, 419 (2002)
  15. Leiggener C., Messo E., Thor A., Zeilhofer H.-F., Hirsch J.-M., A selective laser sintering guide for transferring a virtual plan to real time surgery in composite mandibular reconstruction with free fibula osseous flaps, 10.1016/j.ijom.2008.11.026
  16. Modabber Ali, Legros Christina, Rana Majeed, Gerressen Marcus, Riediger Dieter, Ghassemi Alireza, Evaluation of computer-assisted jaw reconstruction with free vascularized fibular flap compared to conventional surgery: a clinical pilot study : Evaluation of fibular jaw reconstruction, 10.1002/rcs.456
  17. Zhang Yuan Z., Lu Sheng, Chen Bin, Zhao Jian M., Liu Rui, Pei Guo X., Application of computer-aided design osteotomy template for treatment of cubitus varus deformity in teenagers: A pilot study, 10.1016/j.jse.2010.08.029
  18. Murase Tsuyoshi, Oka Kunihiro, Moritomo Hisao, Goto Akira, Yoshikawa Hideki, Sugamoto Kazuomi, Three-Dimensional Corrective Osteotomy of Malunited Fractures of the Upper Extremity with Use of a Computer Simulation System : , 10.2106/jbjs.g.01299
  19. Yushkevich Paul A., Piven Joseph, Hazlett Heather Cody, Smith Rachel Gimpel, Ho Sean, Gee James C., Gerig Guido, User-guided 3D active contour segmentation of anatomical structures: Significantly improved efficiency and reliability, 10.1016/j.neuroimage.2006.01.015
  20. Clinical Orthopaedics and Related Research, 103 (1994)
  21. Stevenson Sharon, Emery Sanford E., Goldberg Victor M., Factors Affecting Bone Graft Incorporation : , 10.1097/00003086-199603000-00009
Bibliographic reference Bellanova, Laura ; Paul, Laurent ; Docquier, Pierre-Louis. Surgical guides (patient-specific instruments) for pediatric tibial bone sarcoma resection and allograft reconstruction. In: Sarcoma, Vol. 2013, no. Article ID 787653, p. [1-7] (2013)
Permanent URL http://hdl.handle.net/2078.1/128664