Sacral tumors may present a difficult problem to the surgeon who desires to ohtain a clear margin of excision. Frequently, tumors in this anatomical location are of a low grade biologically, such as chordomas or chondrosarcomas, and tllerefore unlikely to result in metastatic disease even though they are locally aggressive. Curative ablation of sacral tumors may be considered difficult hecause of the relationship between the anatomical location of the sacrum and the plexus of the lumbosacral nerves and vessels on the one hand and intrapelvic organs on the other. It is also difficult to reconstruct the continuity between pelvis and spine. However, en bloc sacrectomy may well be oncologically indicated, even for sacral tumors, to reduce the incidence of local tumor recurrence leading to fatal disease. In this chapter, we introduce the surgical classification of sacral tumors and the method of total or partial (segmental) en hloc sacrectomy with a T-saw 1,2
KeywordsSarcoma Pyramid Osteosarcoma Dura Chondrosarcomas
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- 1.Tomita K, Kawahara N: The threadwire saw-a new device for cutting bones. J Bone Joint Surg 78A:1915–1917, 1996.Google Scholar
- 7.Shikata J, Yamamuro T, Kotoura Y, et al. Total sacrectomy and reconstruction for primary tumors. J Bone Joint Surg 70A:122–125, 1988.Google Scholar
- 10.Gennari L, Azzarelli A, Quagliuolo V: A posterior approach for the excision of sacral chordoma. J Bone Joint Surg 69:565–568, 1987. Google Scholar
- 13.Hata M, Kawahara N, Tomita K: Prevention of excessive hemorrhage from venous plexus during total sacrectomy [abstract]. J Jpn Spine Res Soc 8:274, 1997.Google Scholar