Pelvic reconstruction with pedicle screw-rod system following pelvic resection type I/II/III in pelvic sarcoma

Abstract

1.1 Background: Reconstruction of pelvic after malignant tumor resection remains a major challenge in orthopedic oncology surgery. To restore weight bearing along anatomical axis while preserving motions is the aim after reconstruction to improve functional outcome thus provide quality of life. The pedicle screw-rod system has proven to be one of acceptable method of reconstructive surgery after pelvic type I, I+IV, and type IV resection due to less risk of complication and satisfactory functional outcome. However, none has been reported the outcome following other type of pelvic resection. 1.2 Methods: We performed hinged arthrodesis using the pedicle screw-rod system (PSRS) to reconstruct the pelvis following pelvic resection type I/II/III in a case of grade 2 Chondrosarcoma of right pelvic involving ilium and extending to the pubic rami. We elaborated techniques, functional outcome and complication following the procedure in 1 year follow up. 1.3 Results: The musculoskeletal tumor society score was 16 and 21 in 6 months and 1 year follow up respectively. Hip motion was 0-45 degrees flexion post operatively. No complications such as infections, deep vein thrombosis, implant loosening and tumor recurrence, were seen in 1 year follow up. 1.4 Conclusions: We recommend the use of pedicle screw-rod system after pelvic resection type 1/II/III. However, longer period of follow up and larger number of cases treated are needed.