title: Proposed Scoring System for Evaluating Neurologic Deficit after Sacral Resection: Functional Outcomes of 170 Consecutive Patients.
abstract: METHODS
  Cross-section analysis.
  
  
  OBJECTIVE
  A quality-of-life oriented scoring system for evaluation of lower limbs, bladder, and bowel functions of patients after sacral tumor resection has been proposed and was adopted in a clinical research.
  
  
  BACKGROUND
  Surgical resections of sacral tumors usually cause postoperative neurologic deficits. A widely agreed scoring system for detailed evaluation of functional outcomes is not yet established.
  
  
  METHODS
  The scoring system has three domains with three items in each domain, being allocated 0 to 3 points of each item according to the degree of functional impairment. Overall function scale is presented in percentage form. In the current single-center cross-section study, it was adopted to evaluate and quantify the postoperative functional outcomes of 170 consecutive patients who underwent sacrectomy.
  
  
  RESULTS
  Significant observer agreement (P < 0.01) was found in all nine items of the proposed system. Detailed functional outcome and difference between each group can be well described by the scoring results. Preservation of bilateral S1 nerve roots preserved majority of motor and sensory function in lower limbs. The probability and degree of urine incontinence (P = 0.003) and abnormal bladder sensation (P = 0.039) was significantly lower in patients with bilateral S3 nerve preserved than those whose unilateral S3 was severed. Patients with unilateral S3 preserved had a lower incidence and degree of dysuria (P = 0.056), constipation (P = 0.059), bowel incontinence (P = 0.007), and abnormal rectal sensation (P = 0.002) than those whose bilateral S3 were sacrificed. Functional outcomes for patients with retained coccyx were better than those with coccyx transected. Functional outcome of different level sacral nerve preservation was semi-quantified and profiled.
  
  
  CONCLUSIONS
  Detailed and intuitive description of neurologic deficits after sacral tumor resection is the major purpose of current scoring system. The ease of use and reproducibility makes it a practical tool to evaluate function status after sacrectomy under oncologic condition.
  
  
  METHODS
  4.
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Beijing, PR China.
authors.forename: Lin
authors.initials: L
authors.lastname: Huang
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.forename: Rongli
authors.initials: R
authors.lastname: Yang
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Tang
authors.forename: Tao
authors.initials: T
authors.lastname: Ji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003248:Constipation / Q000453:epidemiology; D005242:Fecal Incontinence / Q000453:epidemiology; D005260:Female; D020233:Gait Disorders, Neurologic / Q000453:epidemiology; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification* / Q000453:epidemiology*; D012447:Sacrum / Q000294:innervation* / Q000601:surgery*; D012720:Severity of Illness Index; D013125:Spinal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult