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Surgical Strategy for Sacral Tumor Resection

Authors
 Kwang Ryeol Kim  ;  Kyung Hyun Kim  ;  Jeong Yoon Park  ;  Dong Ah Shin  ;  Yoon Ha  ;  Keung Nyun Kim  ;  Dong Kyu Chin  ;  Keun Su Kim  ;  Yong Eun Cho  ;  Sung Uk Kuh 
Citation
 YONSEI MEDICAL JOURNAL, Vol.62(1) : 59-67, 2021-01 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2021-01
MeSH
Adult ; Female ; Humans ; Male ; Osteotomy* / adverse effects ; Retrospective Studies ; Sacrum / surgery* ; Spinal Neoplasms / pathology ; Spinal Neoplasms / physiopathology ; Spinal Neoplasms / surgery*
Keywords
Embolization ; muscle flap ; sacral tumor ; sacrectomy ; spinopelvic reconstruction ; strategy
Abstract
Purpose: This study aimed to present our experiences with a precise surgical strategy for sacrectomy. Materials and methods: This study comprised a retrospective review of 16 patients (6 males and 10 females) who underwent sacrectomy from 2011 to 2019. The average age was 42.4 years old, and the mean follow-up period was 40.8 months. Clinical data, including age, sex, history, pathology, radiographs, surgical approaches, onset of recurrence, and prognosis, were analyzed. Results: The main preoperative symptom was non-specific local pain. Nine patients (56%) complained of bladder and bowel symptoms. All patients required spinopelvic reconstruction after sacrectomy. Three patients, one high, one middle, and one hemi-sacrectomy, underwent spinopelvic reconstruction. The pathology findings of tumors varied (chordoma, n=7; nerve sheath tumor, n=4; giant cell tumor, n=3, etc.). Adjuvant radiotherapy was performed for 5 patients, chemotherapy for three, and combined chemoradiotherapy for another three. Six patients (38%) reported postoperative motor weakness, and newly postoperative bladder and bowel symptoms occurred in 5 patients. Three patients (12%) experienced recurrence and expired. Conclusion: In surgical resection of sacral tumors, the surgical approach depends on the size, location, extension, and pathology of the tumors. The recommended treatment option for sacral tumors is to remove as much of the tumor as possible. The level of root sacrifice is a predicting factor for postoperative neurologic functional impairment and the potential for morbidity. Pre-operative angiography and embolization are recommended to prevent excessive bleeding during surgery. Spinopelvic reconstruction must be considered following a total or high sacrectomy or sacroiliac joint removal.
Files in This Item:
T202101001.pdf Download
DOI
10.3349/ymj.2021.62.1.59
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Kyung Hyun(김경현)
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Kim, Keung Nyun(김긍년)
Park, Jeong Yoon(박정윤) ORCID logo https://orcid.org/0000-0002-3728-7784
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
Ha, Yoon(하윤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182317
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