• Marco Girolami, Maria Sartori, Donato Monopoli-Forleo, Riccardo Ghermandi, Giuseppe Tedesco, Gisberto Evangelisti, Valerio Pipola, Eleonora Pesce, Luigi Falzetti, Milena Fini, and Alessandro Gasbarrini.
• Department of Oncologic and Degenerative Spine Surgery, IRCCS - Istituto Ortopedico Rizzoli, via G.C.Pupilli, 1, 40136, Bologna, Italy.
• Eur Spine J. 2021 Oct 1; 30 (10): 2775-2781.

PurposeIn the present report it is described the design, the manufacturing and the successful surgical implant of one of the first 3D custom titanium vertebra realized with Additive Manufacturing technique and its use for the spinal reconstruction after en-bloc resection for primary osteogenic sarcoma.MethodsClinical case presentation and the design of the 3D custom titanium vertebra was reported. It was also described the complex procedures adopted to evaluate the retrieved device from the histological point of view, as a tumor relapse hit the patient, one year after the reconstruction procedure.ResultsThe histological evaluation confirmed that the resection technique exerts an important role in promoting bone formation: vertebral body osteotomies favored the reconstruction procedure and maximized the contact area between host bone/vertebral prosthesis thus favoring the bone tissue penetration and device colonization.ConclusionThe sharing of these results is very important as they represent the starting point for improving the knowledge starting from the evidence obtained in a challenging clinical condition and with post-operative treatments that could be never reproduced in preclinical model.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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