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Sacral resection with preservation of continence
Surgery, Gynecology & Obstetrics
|September 1, 1986
Summary
Performing high sacral resections involves precise bone division and nerve preservation. Careful dissection ensures functional continuity of sacral nerves, crucial for maintaining continence during tumor removal.
Area of Science:
- Neurosurgery
- Surgical Oncology
- Anatomy
Background:
- High sacral resections present surgical challenges.
- Preserving neurological function, particularly continence, is paramount.
Purpose of the Study:
- To describe a refined technique for high sacral resections.
- To emphasize methods for protecting critical neural structures.
Main Methods:
- Utilizing fine rongeurs to divide fused sacral laminae.
- Employing osteotomes for transection of sacral bodies.
- Careful dissection to displace the dural sac and sacral roots superiorly and laterally.
- Exposure and dissection along the pudendal nerve and ipsilateral sacral roots for large chordomas.
Main Results:
- The described technique allows for controlled division of sacral bone.
- Dissection facilitates safe mobilization of neural elements.
- Preservation of the pudendal nerve and sacral roots is achievable, even in cases with extensive tumors.
Conclusions:
- High sacral resections can be performed effectively with meticulous technique.
- Nerve preservation strategies are vital for maintaining continence after sacral tumor resection.