Abstract
Objective
To evaluate functional and oncological outcomes following sacral resection
Methods
Retrospective review of 97 sacral tumours referred to spinal or oncology units between 2004 and 2009.
Results
61 males, 37 females (average age of 47 (range 3 – 82). Average duration of symptoms 13 months. 17 metastatic disease, excluded from further discussion.
Of the remainder 36/81(44%) underwent surgery – 21 excision, 9 excision and instrumented stabilisation, and 6 curettage.
13(16%) patients were inoperable - 8 advanced disease, 3 unable to establish local control, 2 recurrence. Colostomy was performed in 11/21(52%) patients who underwent excision. Deep wound infections in 6/21(29%). No difference in infection rates between definitive surgery with or without colostomy – 3/11(27%) vs. 3/10(30%). In the instrumented group, no colostomies were performed due to concerns about deep infection and none resulted (0/9). Radiological failure of stabilisation was noted in 7/9(78%). However, functionally, 3/9(33%) were mobilising independently, 3/9(33%) crutches, 2/9(22%) able to transfer and 1/9(11%) undocumented.
Mean follow-up 25 months (range 0-70). Local recurrence in 9/36(25%) of operated patients. Metastasis occurred in 4/36(11%) and mortality 8/36(22%) although follow-up period was noted to be short.
Conclusions
Results are comparable with current literature. Mechanical stabilisation for extensive sacral lesions is challenging. Despite radiological failure in 7/9 instrumented stabilisations, patients were relatively asymptomatic and only 1/9 required revision stabilisation surgery. By design none had colostomies and there were no deep infections.
