SACRECTOMY ASSOCIATED WITH VERTEBRECTOMY: A NEW TECHNIQUE USING DOWEL GRAFTS FROM CADAVERS

Area of Science:

• Orthopedic Surgery
• Spinal Surgery
• Biomedical Engineering

Background:

• Sacrectomy is a complex procedure often requiring significant spinal reconstruction.
• Existing techniques may present challenges in achieving adequate biomechanical stability.
• The lumbosacral transition is particularly vulnerable to stress and instability.

Purpose of the Study:

• To present and evaluate a novel sacrectomy technique.
• To utilize a cadaver iliac crest dowel graft for spinal reconstruction.
• To assess the feasibility and outcomes of this new surgical approach.

Main Methods:

• A case series design was employed to describe the new surgical technique.
• The technique involves four posterior bars and an iliac wing dowel graft for anterior spinal support.
• Vertebrectomy was performed in all three cases, with modifications in surgical staging and access routes.

Main Results:

• The technique was initially performed in two stages (anterior/peritoneal and posterior access).
• A modified one-stage approach using retroperitoneal anterior access was successfully implemented in the third case.
• Surgical times were reduced in the one-stage approach (990 minutes) compared to the two-stage procedures (1250 and 1750 minutes).

Conclusions:

• The described sacrectomy technique offers biomechanical stability crucial for the lumbosacral junction.
• This approach supports the spine and pelvis, promoting enhanced stability.
• The technique holds potential for facilitating earlier patient rehabilitation after complex sacrectomy procedures.