Sakrumun primer tümörlerinin cerrahi tedavisinde total sakrektomi ve lumbopelvik rekonstrüksiyon

Anahtar Kelimeler:

Kondrosarkom, Omurilik neoplazmı, Sakrum, Dev hücreli tümörler, Kemik neoplazmları

Total sacrectomy and lumbopelvic reconstruction for primary tumors of the sacrum

Due to their resistance to oncologic treatment and a low tendency to metastasize, the management of primary tumors of the sacrum is resection with wide margins. We present two male patients (ages 19 years) with chondrosarcoma and a giant cell tumor, respectively. Total sacrectomy and lumbopelvic fixation were performed in both cases. The former patient developed loss of sphincter control and drop foot and died 33 months after surgery from pulmonary metastases. Permanent incontinence and drop foot were observed in the latter. During a follow-up period of 49 months no local recurrences and metastases were encountered.

Keywords:

Chondrosarcoma, Spinal Neoplasms, Sacrum, Giant Cell Tumors, Bone Neoplasms,

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1.Gökaslan ZL, Romsdahl MM, Kroll SS, Walsh GL, Gillis TA, Wildrick DM, et al. Total sacrectomy and Galveston Lrod reconstruction for malignant neoplasms. Technical note. J Neurosurg 1997;87:781-7.
2. Sung HW, Shu WP, Wang HM, Yuai SY, Tsai YB. Surgical treatment of primary tumors of the sacrum. Clin Orthop 1987;(215):91-8.
3. Tomita K, Tsuchiya H. Total sacrectomy and reconstruction for huge sacral tumors. Spine 1990;15:1223-7.
4. Samson IR, Springfield DS, Suit HD, Mankin HJ. Operative treatment of sacrococcygeal chordoma. A review of twentyone cases. J Bone Joint Surg [Am] 1993;75:1476-84.
5. Wuisman P, Harle A, Matthiass HH, Roessner A, Erlemann R, Reiser M. Two-stage therapy in the treatment of sacral tumors. Arch Orthop Trauma Surg 1989;108:255-60.
6.Simpson AH, Porter A, Davis A, Griffin A, McLeod RS, Bell RS. Cephalad sacral resection with a combined extended ilioinguinal and posterior approach. J Bone Joint Surg [Am] 1995;77:405-11.
7. Stener B. Complete removal of vertebrae for extirpation of tumors. A 20-year experience. Clin Orthop 1989;(245):72-82.
8. Shikata J, Yamamuro T, Shimizu K, Shimizu K, Kotoura Y. Surgical treatment of giant-cell tumors of the spine. Clin Orthop 1992;(278):29-36.
9. Turcotte RE, Sim FH, Unni KK. Giant cell tumor of the sacrum. Clin Orthop 1993;(291):215-21.
10. Shikata J, Yamamuro T, Mikawa Y, Kotoura Y, Iida H. Instrumentation surgery for primary tumors of the spine. Arch Orthop Trauma Surg 1989;108:144-9.
11. Santi MD, Mitsunaga MM, Lockett JL. Total sacrectomy for a giant sacral schwannoma. A case report. Clin Orthop 1993; (294):285-9.
12. Spiegel DA, Richardson WJ, Scully SP, Harrelson JM. Longterm survival following total sacrectomy with reconstruction for the treatment of primary osteosarcoma of the sacrum. A case report. J Bone Joint Surg [Am] 1999;81:848-55.
13. Allen BL Jr, Ferguson RL. The Galveston technique for L rod instrumentation of the scoliotic spine. Spine 1982;7:276-84.
14. Gunterberg B, Kewenter J, Petersen I, Stener B. Anorectal function after major resections of the sacrum with bilateral or unilateral sacrifice of sacral nerves. Br J Surg 1976;63: 546-54.
15. Gunterberg B, Romanus B, Stener B. Pelvic strength after major amputation of the sacrum. An experimental study. Acta Orthop Scand 1976;47:635-42.
16. Guyer DW, Yuan HA, Werner FW, Frederickson BE, Murphy D. Biomechanical comparison of seven internal fixation devices for the lumbosacral junction. Spine 1987; 12:569-73.