Treatment of neoplastic diseases of the sacrum

Sacral neoplasms constitute a wide range of pathological entities including primary and metastatic as well as benign and malignant conditions. Often these lesions are large at the time of initial diagnosis and surgical cure may be difficult. Nonetheless, surgery may be indicated for a wide range of reasons including tissue diagnosis, palliation of pain, preservation of neurological function, or attempts for curative resection. There are numerous surgical approaches to lesions of this area which require a complete understanding of the neural, pelvic, and bony anatomy. For this reason we utilize a multidisciplinary team approach when treating these lesions. This allows for the combination of expertise from areas such as general surgery, orthopedic surgery, and neurosurgery that optimizes the treatment of these patients. In this article we review the basic techniques of diagnosis and treatment of these lesions. This overview includes the relative anatomy, symptoms, diagnosis, imaging, operative indications, surgical approaches, and potential complications.