Posterior approach for radical excision of sacral chordoma

Sacral chordoma is a rare primary malignant tumour of bone. Operations to excise these tumours are complex, time consuming and involve considerable blood loss. We describe the use of a posterior approach to excise chordomas from the sacrum of five patients without visceral involvement. This approach is less complex than combined approaches previously described. No distal recurrences had occurred at a mean followup of 5 years. One patient developed local recurrence and was successfully treated by wide local excision. Postoperative morbidity was low with regard to urinary and faecal continence problems. We recommend the use of Mersilene mesh to prevent herniation through the sacral defect.