Abstract
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
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References
Tomita K, Kawahara N: The threadwire saw-a new device for cutting bones. J Bone Joint Surg 78A:1915–1917, 1996.
Tomita K, Kawahara N, Baba R, et al: Total en bloc spondylectomy for solitary spinal metastases. Int Orthop 18:291–298, 1994.
Enneking WF: A system of staging musculoskeletal neoplasms. Clin Orthop 204:9–24, 1986.
Kaiser TE, et al: Clinicopathologic study of sacrococcygeal chordoma. Cancer 54:2574–2578, 1984.
Gunterberg B, Kewentcr N, Peterson I, et al: Anorectal function after major resections of the sacrum with bilateral or unilateral sacrifice of sacral nerves. Br J Surg 63:546–554, 1976.
Stener B, Gunterberg B: High amputation of the sacrum for extirpation of tumors, principles and technique. Spine 3:351–366, 1978.
Shikata J, Yamamuro T, Kotoura Y, et al. Total sacrectomy and reconstruction for primary tumors. J Bone Joint Surg 70A:122–125, 1988.
Tomita K, Tsuchiya H: Total sacrectomy and reconstruction for huge sacral tumors. Spine 15:1223–1227,1990.
Andreoli F, Balloni F, Bigiotti A, et al: Anorectal continence and bladder function. Effects of major sacral resection. Dis Colon Rec 29:647–652, 1986.
Gennari L, Azzarelli A, Quagliuolo V: A posterior approach for the excision of sacral chordoma. J Bone Joint Surg 69:565–568, 1987.
Torelli T, Campo B, Ordesi G, et al: Sacral chordoma and rehabilitative treatment of urinary disorders. Tumori 74:475–478, 1988.
Gunterberg B, Romanus B, Stener B: Pelvic strength after major amputation of the sacrum. Acta Orthop Scand 47:635–642, 1976.
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.
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Tomita, K., Hata, M., Tsuchiya, H., Murakami, H., Kawahara, N. (2003). En Bloc Sacrectomy. In: Surgical Approaches to the Spine. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-0009-0_29
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DOI: https://doi.org/10.1007/978-1-4613-0009-0_29
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-6508-5
Online ISBN: 978-1-4613-0009-0
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