title: Novel use of a threadwire saw for high sacral amputation. Technical note and description of operative technique.
abstract: The authors describe and demonstrate an innovative modification of the osteotomy procedure required to achieve a supraforaminal high sacral amputation in a patient harboring a large sacral chordoma. Via a combined anterior-posterior approach, three carefully placed threadwire saws were used to create releasing osteotomies through specific portions of the dorsal iliac crests and through the axial midportion of the S-1 vertebral body. The threadwire saws are pulled away from neurovascular and visceral structures, ensuring greater protection. Other advantages include markedly reduced blood loss while performing the osteotomies, a high degree of cutting accuracy, negligible bone loss, and ease and speed of bone cutting.
authors.affiliation: Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77230-1402, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Bohinski
authors.forename: Ehud
authors.initials: E
authors.lastname: Mendel
authors.forename: Laurence D
authors.initials: LD
authors.lastname: Rhines
mesh_terms: D000671:Amputation, Surgical / Q000295:instrumentation* / Q000379:methods; D002817:Chordoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D011859:Radiography; D012447:Sacrum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*