Image-guided resection of aggressive sacral tumors

Area of Science:

• Neurosurgery
• Orthopedic Oncology
• Surgical Oncology

Background:

• Aggressive sacral tumors present significant surgical challenges.
• Management requires careful consideration of tumor type, size, and location.
• Potential risks include neural compression, instability, and incomplete resection.

Purpose of the Study:

• To identify and discuss operative nuances of image-guided surgery for aggressive sacral tumors.
• To review literature on diagnosis and surgical treatment of these tumors.
• To share institutional experience and surgical pearls.

Main Methods:

• Retrospective case series of 6 patients treated between 2009-2016.
• Utilized image-guided surgery with cone-beam CT (O-arm) technology.
• Comprehensive literature review of chordomas, chondrosarcomas, GCTs, and osteosarcomas.

Main Results:

• All 6 patients underwent image-guided surgery.
• Detailed surgical techniques and illustrative cases are presented.
• Literature review organized information by tumor type, including background, imaging, treatment, and surgical pearls.

Conclusions:

• Image-guided surgery offers benefits in managing aggressive sacral tumors.
• Operative nuances tailored to tumor type can prevent complications.
• Anecdotal evidence suggests reduced blood loss, lower recurrence, and preserved function.