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Total sacrectomy and reconstruction for sacral tumors.
Spine (Phila Pa 1976). 2003 Aug 01; 28(15):E296-301.S

Abstract

STUDY DESIGN

Report of three patients in whom the lumbosacral junctions were successfully restored by spinal instrumentations after total sacrectomies.

OBJECTIVES

To describe the surgical technique of the reconstruction of the continuity between the pelvic ring and spinal column by using a transpedicular and iliac screw system.

SUMMARY OF BACKGROUND DATA

Although there have been case reports about reconstruction methods after total sacrectomy, biomechanical, and technical problems still remain unresolved.

METHODS

Total sacrectomy was carried out in three cases: two with chordomas and one with a recurrent giant cell tumor. In the first case, reconstruction was achieved with Zielke transpedicular screw and rod system and a sacral rod. The other two patients were reconstructed using a transpedicular and iliac screw system and a sacral rod for bilateral fixation of the iliac wings. In the third patient, the vertical rods were connected to transverse rod with rod connectors.

RESULTS

No instrumentation failure was observed, and the continuity between the pelvic wing and spinal column was established with the instrumentation and bone grafting. Although one patient died of metastatic chordoma, the lumbosacral junction was successfully reconstructed with the instrumentation. The other two patients could stand with double crutches 13 and 2 years after surgery, respectively.

CONCLUSIONS

Total sacrectomy is a feasible operation for primary malignant tumors involving the entire sacrum. Reconstruction of the union between the lumbar spine and the ilia with spinal instrumentation achieves stabilization suitable for ambulation.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Japan. doita@med.kobe-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

12897508

Citation

Doita, Minoru, et al. "Total Sacrectomy and Reconstruction for Sacral Tumors." Spine, vol. 28, no. 15, 2003, pp. E296-301.
Doita M, Harada T, Iguchi T, et al. Total sacrectomy and reconstruction for sacral tumors. Spine. 2003;28(15):E296-301.
Doita, M., Harada, T., Iguchi, T., Sumi, M., Sha, H., Yoshiya, S., & Kurosaka, M. (2003). Total sacrectomy and reconstruction for sacral tumors. Spine, 28(15), E296-301.
Doita M, et al. Total Sacrectomy and Reconstruction for Sacral Tumors. Spine. 2003 Aug 1;28(15):E296-301. PubMed PMID: 12897508.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Total sacrectomy and reconstruction for sacral tumors. AU - Doita,Minoru, AU - Harada,Toshihiko, AU - Iguchi,Tetsuhiro, AU - Sumi,Masatoshi, AU - Sha,Hidenori, AU - Yoshiya,Shinichi, AU - Kurosaka,Masahiro, PY - 2003/8/5/pubmed PY - 2004/2/21/medline PY - 2003/8/5/entrez SP - E296 EP - 301 JF - Spine JO - Spine VL - 28 IS - 15 N2 - STUDY DESIGN: Report of three patients in whom the lumbosacral junctions were successfully restored by spinal instrumentations after total sacrectomies. OBJECTIVES: To describe the surgical technique of the reconstruction of the continuity between the pelvic ring and spinal column by using a transpedicular and iliac screw system. SUMMARY OF BACKGROUND DATA: Although there have been case reports about reconstruction methods after total sacrectomy, biomechanical, and technical problems still remain unresolved. METHODS: Total sacrectomy was carried out in three cases: two with chordomas and one with a recurrent giant cell tumor. In the first case, reconstruction was achieved with Zielke transpedicular screw and rod system and a sacral rod. The other two patients were reconstructed using a transpedicular and iliac screw system and a sacral rod for bilateral fixation of the iliac wings. In the third patient, the vertical rods were connected to transverse rod with rod connectors. RESULTS: No instrumentation failure was observed, and the continuity between the pelvic wing and spinal column was established with the instrumentation and bone grafting. Although one patient died of metastatic chordoma, the lumbosacral junction was successfully reconstructed with the instrumentation. The other two patients could stand with double crutches 13 and 2 years after surgery, respectively. CONCLUSIONS: Total sacrectomy is a feasible operation for primary malignant tumors involving the entire sacrum. Reconstruction of the union between the lumbar spine and the ilia with spinal instrumentation achieves stabilization suitable for ambulation. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/12897508/Total_sacrectomy_and_reconstruction_for_sacral_tumors_ L2 - http://dx.doi.org/10.1097/01.BRS.0000083230.12704.E3 DB - PRIME DP - Unbound Medicine ER -