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Vertebral reconstruction with 3D printed titanium prosthesis for a patient at risk of paralysis at the Rizzoli-Sicilia Department

October 23rd, 2020

An 44-year-old man turned to the Rizzoli-Sicilia Department due to a tetraparesis: a severe compression of the cervical cord caused the paralysis of all four limbs.

A critical situation, making the risk of a complete paralysis plausible. Therefore, he was operated by the director of the 1st Orthopaedic and Traumatologic Clinic, Cesare Faldini, together with the equipe of the department of Bagheria, directed by Giovanni Pignatti.

The reconstruction was made with the use of a 3D printed porous titanium prosthesis and a plate.

The patient was awakened after five hours in the operating room and immediately showed the ability to move his arms and legs.
The surgery was performed after a very rapid diagnostic pathway, involving more than ten professionals: orthopedists, anesthesiologists, nurses and technicians.

Professor Faldini explained: " we reached the area of the spinal cord compression through an anterior access, after the radiographic controls and the placement of electrophysiological controls to monitor the spinal cord during surgery. Despite removing a vertebral disc, the cord also required the removal of part of a vertebral body and of almost the entire upper vertebra.”

Prof. Cesare Faldini with the team in the operating room at the Rizzoli-Sicilia Department

A post-surgery CT scan performed by the radiology centre of Villa Santa Teresa, the facility where the Rizzoli Institute is based in Sicily, showed the successful vertebral reconstruction.

"The patient has been discharged," Faldini continued . “The recovery of the spinal cord is long and winding, but there are already clear signs of recovery: he can stand up on his own, the sensitivity in his shoulders and lower limbs is returning, he is also regaining  properly the use of his hands.
We expect a further improvement with an adequate rehabilitation. Nevertheless, the real goal of this surgical operation has definitely been avoiding a complete paralysis, inexorable without a prompt intervention.”
The type of intervention and its timing are even more significant considering this particularly critical period for the entire National Health Service.

“This case demonstrates how our professionals are able to deal with extremely complex situations " General Director of the Rizzoli Institute, Anselmo Campagna said. “Thanks to the continuous connection between the two sites in Bologna and Bagheria - which will be further strengthened in the coming months - and to the willingness of the two Regions involved, we have been able to activate and develop an orthopaedic centre of excellence in Sicily that boasts the full expertise of the Rizzoli Institute".

The Rizzoli-Sicilia Department performs an average of 1.500 surgical operations per year and over 15 K outpatient visits.
It was established in 2011 thanks to an agreement between the Sicilian Region and the Emilia-Romagna Region.
"The quality of life of people is one of the main purposes of medical care. News like this makes us proud of our health system, in this case of the Rizzoli Institute“, Councillor for Health Policies of the Emilia-Romagna Region, Raffaele Donini said. “I send a virtual hug to the patient who has regained a normal quality of life, and I thank the health professionals who took care of him at the Rizzoli-Sicily Department. We are proud of you."

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