Wide resection of sacral chordoma via a posterior approach

Abstract

Purpose The study was carried out to report the results of wide resection in sacral chordoma using a posterior approach and gauze packing technique. Materials and methods The study was carried out between 1990 and 2002; there were 21 patients who underwent the operation. Fourteen patients were male and seven were female. Their ages ranged between 29 and 75 years. Most of the patients presented with sacral mass, pain and neurological deficit. Total sacrectomy and bone reconstruction were carried out in 12 patients. Subtotal sacrectomy was carried out in the remaining nine patients. All patients were followed up for at least seven years. Results All survived after the operation. Operative time ranged between five and ten hours. All patients needed blood transfusion which ranged between four and 11 units. After the operation, all patients had a certain degree of bowel and bladder dysfunction. Five patients had local complications including infection in three patients with wound disruption and two patients with a seroma. During the follow-up, three patients (14%) had tumour recurrence and one of the patients expired. The remaining 18 patients were still tumour-free at the seven-year follow-up. Conclusion Wide resection via the posterior approach and gauze packing technique could be used for management of sacral chordoma with acceptable results.

What Are the Functional Outcomes After Total Sacrectomy Without Spinopelvic Reconstruction?

“…Tomita and Tsuchiya [23] reported three patients and all patients were able to walk, one with no walking aid, one with a cane, and one with an ankle-foot orthosis. However, in some case report or series, not many patients with reconstruction were not able to ambulate [2,5,12] or walk with a cane only in the house [25]. There are few studies regarding total sacrectomy without reconstruction (Table 4) and most patients were able to ambulate with a walker or cane [11,19,22].…”

“…Questions/purposes (1) What is the functional outcome and ambulatory status of patients after total sacrectomy without spinopelvic reconstruction? (2) What is the walking ability and ambulatory status of patients when categorized by the location of the iliosacral resection relative to the sacroiliac joint? (3) What complications and reoperations occur after this procedure?…”

“…(2) What is the walking ability and ambulatory status of patients when categorized by the location of the iliosacral resection relative to the sacroiliac joint? (3) What complications and reoperations occur after this procedure?…”

Wide local resection of sacral chordoma through posterior midline approach

“…It also prevents intraoperative bleeding by tamponade effect on the intrapelvic venous plexus. 19 Similar technique was used successfully in this study and none had visceral organs or great vessels injury during bone cutting through posterior approach.…”

Radical neurosurgical excision of sacral tumors, causing compression of neural structures, the results of treatment

“…При таких вмешательствах осуществляют декомп-рессию нервных структур, удаляют опухоль, фик-сируют позвоночник с тазовым кольцом [4].…”