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A new type of reconstruction of the hemipelvis after type 3 amputative sacrectomy using pedicled fibula: technical note.
J Neurosurg Spine. 2014 Aug; 21(2):195-202.JN

Abstract

This is a technical note of pelvic reconstruction performed by an advanced multidisciplinary team. The authors report a new 3-stage reconstruction of the hemipelvis after Type 3 sacrectomy involving instrumented spinoiliac arthrodesis and pedicled fibula grafting in 2 patients. The anterior stage of the procedure begins with a transabdominal approach to mobilize the viscera and to free up the tumor from the vessels. The posterior divisions of internal iliac vessels, the middle sacral vessels, and the lateral sacral vessels are then ligated. An anterior vertebrectomy is done at the appropriate level, followed by an anterior osteotomy through the lateral planed surgical margin of the sacrum close to the salvaged sacroiliac joint. The second stage includes a major sacral resection with lower-extremity amputation from the pubic symphysis through the intact side of the sacrum, ipsilateral pedicled fibula harvesting, and closure with an ipsilateral pedicled quadriceps flap. The final stage involves reconstruction with lumboiliac instrumentation. The pedicled fibular graft left from the second stage is then placed distally within the previously created iliopectineal docking site and proximally within the L-5 docking site. The authors believe that this is a feasible and reproducible technique with theoretical advantages that have to be proved in the long-term follow-up.

Authors+Show Affiliations

Centre for Spinal Studies and Surgery, Nottingham University Hospital, Queens Medical Centre, Nottingham, United Kingdom;No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24766289

Citation

Starantzis, Konstantinos A., et al. "A New Type of Reconstruction of the Hemipelvis After Type 3 Amputative Sacrectomy Using Pedicled Fibula: Technical Note." Journal of Neurosurgery. Spine, vol. 21, no. 2, 2014, pp. 195-202.
Starantzis KA, Sakellariou VI, Rose PS, et al. A new type of reconstruction of the hemipelvis after type 3 amputative sacrectomy using pedicled fibula: technical note. J Neurosurg Spine. 2014;21(2):195-202.
Starantzis, K. A., Sakellariou, V. I., Rose, P. S., Yaszemski, M. J., & Papagelopoulos, P. J. (2014). A new type of reconstruction of the hemipelvis after type 3 amputative sacrectomy using pedicled fibula: technical note. Journal of Neurosurgery. Spine, 21(2), 195-202. https://doi.org/10.3171/2014.1.SPINE13245
Starantzis KA, et al. A New Type of Reconstruction of the Hemipelvis After Type 3 Amputative Sacrectomy Using Pedicled Fibula: Technical Note. J Neurosurg Spine. 2014;21(2):195-202. PubMed PMID: 24766289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A new type of reconstruction of the hemipelvis after type 3 amputative sacrectomy using pedicled fibula: technical note. AU - Starantzis,Konstantinos A, AU - Sakellariou,Vasileios I, AU - Rose,Peter S, AU - Yaszemski,Michael J, AU - Papagelopoulos,Panayiotis J, Y1 - 2014/04/25/ PY - 2014/4/29/entrez PY - 2014/4/29/pubmed PY - 2014/9/24/medline KW - VRAM = vertical rectus abdominis muscle flap KW - fibula KW - pelvis KW - reconstruction KW - sacral KW - sacrectomy KW - vascularized tumor SP - 195 EP - 202 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 21 IS - 2 N2 - This is a technical note of pelvic reconstruction performed by an advanced multidisciplinary team. The authors report a new 3-stage reconstruction of the hemipelvis after Type 3 sacrectomy involving instrumented spinoiliac arthrodesis and pedicled fibula grafting in 2 patients. The anterior stage of the procedure begins with a transabdominal approach to mobilize the viscera and to free up the tumor from the vessels. The posterior divisions of internal iliac vessels, the middle sacral vessels, and the lateral sacral vessels are then ligated. An anterior vertebrectomy is done at the appropriate level, followed by an anterior osteotomy through the lateral planed surgical margin of the sacrum close to the salvaged sacroiliac joint. The second stage includes a major sacral resection with lower-extremity amputation from the pubic symphysis through the intact side of the sacrum, ipsilateral pedicled fibula harvesting, and closure with an ipsilateral pedicled quadriceps flap. The final stage involves reconstruction with lumboiliac instrumentation. The pedicled fibular graft left from the second stage is then placed distally within the previously created iliopectineal docking site and proximally within the L-5 docking site. The authors believe that this is a feasible and reproducible technique with theoretical advantages that have to be proved in the long-term follow-up. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/24766289/A_new_type_of_reconstruction_of_the_hemipelvis_after_type_3_amputative_sacrectomy_using_pedicled_fibula:_technical_note_ L2 - https://thejns.org/doi/10.3171/2014.1.SPINE13245 DB - PRIME DP - Unbound Medicine ER -