Radical excision of malignant sacral tumors using a modified threadwire saw.
BACKGROUND
Surgical treatment of malignant sacral tumors is difficult, and has a high rate of recurrence.


OBJECTIVE
The aim of this study was to examine the wide margin of large and small malignant sacral tumors using a threadwire saw (T-saw).


METHODS
We devised a flexible silver guide probe connected to a modified threadwire saw by a suture thread to perform osteotomies. We operated on 10 patients with sacral tumors using this device. The sacral excisions were performed via a posterior approach by four surgeons (two on each side) working simultaneously.


RESULTS
We obtained a wide margin in all cases and no recurrence, after a mean follow-up of 4 years 2 months (range, 1 year 8 months-7 years 8 months). In one case, one nerve root on the right side was injured.


CONCLUSIONS
Our new method is easier and faster than the conventional method in cases in which bilateral sacral nerve root canals require sectioning, and it produces a wide tumor margin.
Osaka
Shunzo
S
Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan. osamu-k@eva.hi-ho.ne.jp
Kondoh
Osamu
O
Yoshida
Yukihiro
Y
Ryu
Junnosuke
J
D000328:Adult; D000368:Aged; D001864:Bone Wires; D002817:Chordoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012445:Sacrococcygeal Region; D012447:Sacrum / Q000601:surgery*; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D013525:Surgical Instruments; D013537:Sutures