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Total sacrectomy and reconstruction for sacral tumors
Minoru Doita1, Toshihiko Harada, Tetsuhiro Iguchi
1Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Japan. doita@med.kobe-u.ac.jp
Spine
|August 5, 2003
Summary
Spinal instrumentation successfully restored lumbosacral junctions after total sacrectomy in three patients with malignant tumors. This surgical technique enables pelvic ring and spinal column reconstruction, facilitating ambulation.
Area of Science:
- Spinal surgery
- Oncology
- Orthopedic reconstruction
Background:
- Reconstruction after total sacrectomy presents unresolved biomechanical and technical challenges.
- Existing case reports offer limited guidance on effective reconstruction methods.
Observation:
- Three patients underwent total sacrectomy for malignant tumors (two chordomas, one giant cell tumor).
- Surgical reconstruction utilized transpedicular and iliac screw systems with spinal instrumentation and bone grafting.
Findings:
- No instrumentation failures occurred, achieving continuity between the pelvic wings and spinal column.
- Successful lumbosacral junction reconstruction allowed two patients to ambulate with crutches for extended periods.
- One patient succumbed to metastatic chordoma, but the reconstruction remained intact.
Implications:
- Total sacrectomy is a viable surgical option for extensive sacral tumors.
- Spinal instrumentation provides stable reconstruction for lumbar spine-to-ilium union, supporting patient ambulation.
- This technique offers a promising approach for managing complex sacral tumor resections.