En bloc sacrectomy and reconstruction: technique modification for pelvic fixation.
BACKGROUND
When the management of sacral tumors requires partial or complete sacrectomy, the spinopelvic apparatus must be reconstructed. This is a challenging and infrequently performed operation, and as such, many spine surgeons are unfamiliar with techniques available to carry out these procedures.


METHODS
A 34-year-old man presented with severe low back pain, mild left ankle dorsiflexion weakness, and left S1 paresthesias. Imaging revealed a large sacral mass extending into the L5/S1 and S1/S2 neural foramina as well as the presacral visceral and vascular structures. Needle biopsy of this mass demonstrated a low-grade chondrosarcoma. A 2-stage anterior/posterior en bloc sacrectomy with a novel modification of the Galveston L-rod pelvic ring reconstruction was carried out. Our modification takes advantage of new materials and implant technology to offer another alternative in reconstruction of the spinopelvic junction.


CONCLUSIONS
Understanding the anatomy and biomechanics of the spinopelvic apparatus and the lumbosacral junction, as well as having a familiarity with the various techniques available for carrying out sacrectomy and pelvic ring reconstruction, will enable the spine surgeon to effectively manage sacral tumors.
Newman
C Benjamin
CB
Division of Neurosurgery, University of California, San Diego Medical Center, CA 92103, USA. cbnewman@ucsd.edu
Keshavarzi
Sassan
S
Aryan
Henry E
HE
D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods; D002813:Chondrosarcoma / Q000175:diagnosis / Q000601:surgery*; D017586:Diskectomy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D010027:Osteotomy / Q000379:methods; D010348:Patient Care Team; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D019919:Prosthesis Implantation / Q000379:methods*; D012446:Sacroiliac Joint / Q000601:surgery*; D012447:Sacrum / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*