A case study using total en bloc sacrectomy and neuroanastomosis for sacral tumor.
OBJECTIVE
To study the oncological and functional outcomes of patients undergoing en bloc tumor excisions and neuroanastomosis for sacral tumors.


METHODS
Five patients who underwent en bloc total sacrectomy and neuroanastomosis from January 2006 to August 2010 were observed. A procedure combining the anterior and posterior approach was used on these patients. Neuroanastomosis was performed after sacrectomy. Perioperative complications and postoperative functions in these patients were analyzed.


RESULTS
All patients had partial or complete loss of bladder and bowel functions, foot plantar flexion weakness and increased residual urine volume after surgery. Three patients were ambulatory. After 6 months, four patients were disease-free, two patients reported slightly improved bladder and bowel functions, four patients could ambulate with a walking stick and the one patient with sarcoma had other metastases and died after 8 months. After 1 year, two patients reported improved bladder and bowel functions, one patient slightly improved bladder and bowel functions and there was no change in one patient.


CONCLUSIONS
Successful neuroanastomosis of sacral nerve roots does not occur in all patients, but lower limb, bladder and bowel functions can improve with time after the surgery.
Department of Orthopaedics, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China.
Guoquan
G
Zheng
Songhua
S
Xiao
Yonggang
Y
Zhang
Xuesong
X
Zhang
Zheng
Z
Wang
Yan
Y
Wang
D000328:Adult; D018286:Carcinoma, Giant Cell / Q000601:surgery; D002817:Chordoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D012007:Rectum / Q000502:physiology; D012447:Sacrum / Q000601:surgery*; D012509:Sarcoma / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D013125:Spinal Neoplasms / Q000601:surgery*; D001743:Urinary Bladder / Q000502:physiology; D016138:Walking; D055815:Young Adult