title: Conversion of high sacral to midsacral amputation via S-2 nerve preservation during partial S-2 sacrectomy for chordoma.
abstract: Chordomas of the sacrum require en bloc resection to reduce the risk of recurrence, but this may sacrifice nerves vital to bladder, bowel, and sexual function. High, mid-, and low sacral amputations have been previously classified based on nerve root sacrifice, not bony amputation. Sacrifice of the S-2 nerves or those above results in a high sacral amputation, but preserving the S-2 nerves converts it into a midsacral amputation. Preservation of the S-2 nerves has been shown to improve functional outcome, despite the bony osteotomy being unchanged. Thus, keeping the same bony amputation while preserving the S-2 nerve roots may allow for improved functional outcome while still achieving the same goal of oncological resection. Preservation of the S-2 nerves may be particularly difficult during amputation at the S-2 pedicle or above, and the authors describe their technique for preserving the S-2 nerves during partial sacrectomy at or just above the S-2 pedicle. Four cases of sacral chordoma resections are presented to illustrate the technique.
authors: Departments of Neurological Surgery and.
authors: Rajiv
authors: R
authors: Saigal
authors: Daniel C
authors: DC
authors: Lu
authors: Donna Y
authors: DY
authors: Deng
authors: Dean
authors: D
authors: Chou
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000379:methods*; D002817:Chordoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D012447:Sacrum / Q000601:surgery*; D013125:Spinal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome