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En bloc sacrectomy and reconstruction: technique modification for pelvic fixation.
Surg Neurol. 2009 Dec; 72(6):752-6; discussion 756.SN

Abstract

BACKGROUND

When the management of sacral tumors requires partial or complete sacrectomy, the spinopelvic apparatus must be reconstructed. This is a challenging and infrequently performed operation, and as such, many spine surgeons are unfamiliar with techniques available to carry out these procedures.

CASE DESCRIPTION

A 34-year-old man presented with severe low back pain, mild left ankle dorsiflexion weakness, and left S1 paresthesias. Imaging revealed a large sacral mass extending into the L5/S1 and S1/S2 neural foramina as well as the presacral visceral and vascular structures. Needle biopsy of this mass demonstrated a low-grade chondrosarcoma. A 2-stage anterior/posterior en bloc sacrectomy with a novel modification of the Galveston L-rod pelvic ring reconstruction was carried out. Our modification takes advantage of new materials and implant technology to offer another alternative in reconstruction of the spinopelvic junction.

CONCLUSION

Understanding the anatomy and biomechanics of the spinopelvic apparatus and the lumbosacral junction, as well as having a familiarity with the various techniques available for carrying out sacrectomy and pelvic ring reconstruction, will enable the spine surgeon to effectively manage sacral tumors.

Authors+Show Affiliations

Division of Neurosurgery, University of California, San Diego Medical Center, CA 92103, USA. cbnewman@ucsd.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19665193

Citation

Newman, C Benjamin, et al. "En Bloc Sacrectomy and Reconstruction: Technique Modification for Pelvic Fixation." Surgical Neurology, vol. 72, no. 6, 2009, pp. 752-6; discussion 756.
Newman CB, Keshavarzi S, Aryan HE. En bloc sacrectomy and reconstruction: technique modification for pelvic fixation. Surg Neurol. 2009;72(6):752-6; discussion 756.
Newman, C. B., Keshavarzi, S., & Aryan, H. E. (2009). En bloc sacrectomy and reconstruction: technique modification for pelvic fixation. Surgical Neurology, 72(6), 752-6; discussion 756. https://doi.org/10.1016/j.surneu.2009.02.008
Newman CB, Keshavarzi S, Aryan HE. En Bloc Sacrectomy and Reconstruction: Technique Modification for Pelvic Fixation. Surg Neurol. 2009;72(6):752-6; discussion 756. PubMed PMID: 19665193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - En bloc sacrectomy and reconstruction: technique modification for pelvic fixation. AU - Newman,C Benjamin, AU - Keshavarzi,Sassan, AU - Aryan,Henry E, Y1 - 2009/08/07/ PY - 2008/11/03/received PY - 2009/02/10/accepted PY - 2009/8/12/entrez PY - 2009/8/12/pubmed PY - 2010/2/2/medline SP - 752-6; discussion 756 JF - Surgical neurology JO - Surg Neurol VL - 72 IS - 6 N2 - BACKGROUND: When the management of sacral tumors requires partial or complete sacrectomy, the spinopelvic apparatus must be reconstructed. This is a challenging and infrequently performed operation, and as such, many spine surgeons are unfamiliar with techniques available to carry out these procedures. CASE DESCRIPTION: A 34-year-old man presented with severe low back pain, mild left ankle dorsiflexion weakness, and left S1 paresthesias. Imaging revealed a large sacral mass extending into the L5/S1 and S1/S2 neural foramina as well as the presacral visceral and vascular structures. Needle biopsy of this mass demonstrated a low-grade chondrosarcoma. A 2-stage anterior/posterior en bloc sacrectomy with a novel modification of the Galveston L-rod pelvic ring reconstruction was carried out. Our modification takes advantage of new materials and implant technology to offer another alternative in reconstruction of the spinopelvic junction. CONCLUSION: Understanding the anatomy and biomechanics of the spinopelvic apparatus and the lumbosacral junction, as well as having a familiarity with the various techniques available for carrying out sacrectomy and pelvic ring reconstruction, will enable the spine surgeon to effectively manage sacral tumors. SN - 1879-3339 UR - https://www.unboundmedicine.com/medline/citation/19665193/En_bloc_sacrectomy_and_reconstruction:_technique_modification_for_pelvic_fixation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-3019(09)00166-9 DB - PRIME DP - Unbound Medicine ER -