Reconstruction with a 3D-printed prosthesis and internal fixation with novel four-rod technique after en bloc resection of meningiomas in the lumbosacral region (l5-s3) without rectum/bladder function sacrifice: technical case report

Spinal meningiomas are rare in the lumbosacral region.The best solution is complete tumor resection.However, how to preserve the patient's rectum/bladder function after en bloc resection is still a considerable challenge, even without spinopelvic reconstruction.The use of the three-dimensional (3D) printing technique may simplify it.The final step after restoration is the establishment of rigid fixation.The purpose of this article was to present a case of lumbosacral meningiomas treated by en bloc resection, 3D-printed prosthesis reconstruction, and fixation with pedicle screws and cortical bone trajectory screws.A 35-year-old woman has suffered from lumbosacral and two legs pain for two months.During the previous month, she limped, and her strength was 4/5 in both legs.Magnetic resonance imaging (MRI) revealed space-occupying lesions from the lumbar 5 (L5) to sacral 3 (S3) vertebral bodies.The previous biopsy confirmed the lesions were spinal meningiomas.The patient underwent an en bloc resection followed by 3D-printed prosthesis reconstruction and internal fixation with a novel technique.The surgery was successful, and the patient recovered well postoperatively according to follow-up examination.En bloc resection of L5-S3 meningiomas without rectum/bladder function sacrifice is a feasible procedure, and 3D-printed prosthesis provides an alternative method for the reconstruction of the spinopelvic ring.The rigid fixation construct using the novel four-rod technique could develop strong bony fusion.