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The Bone & Joint Journal
Vol. 103-B, Issue 8 | Pages 1414 - 1420
1 Aug 2021
Wellings EP Houdek MT Owen AR Bakri K Yaszemski MJ Sim FH Moran SL Rose PS

Aims

Orthopaedic and reconstructive surgeons are faced with large defects after the resection of malignant tumours of the sacrum. Spinopelvic reconstruction is advocated for resections above the level of the S1 neural foramina or involving the sacroiliac joint. Fixation may be augmented with either free vascularized fibular flaps (FVFs) or allograft fibular struts (AFSs) in a cathedral style. However, there are no studies comparing these reconstructive techniques.

Methods

We reviewed 44 patients (23 female, 21 male) with a mean age of 40 years (SD 17), who underwent en bloc sacrectomy for a malignant tumour of the sacrum with a reconstruction using a total (n = 20), subtotal (n = 2), or hemicathedral (n = 25) technique. The reconstructions were supplemented with a FVF in 25 patients (57%) and an AFS in 19 patients (43%). The mean length of the strut graft was 13 cm (SD 4). The mean follow-up was seven years (SD 5).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVIII | Pages 209 - 209
1 Sep 2012
Rose PS Yaszemski MJ Wenger DE Sim FH
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Purpose

Curative treatment of malignancies in the sacrum and lumbar spine frequently requires en-bloc spinopelvic resection. There is no standard classification of these procedures. We present a classification of these resections based on analysis of 45 consecutive cases of oncologic spinopelvic resections. This classification implies a surgical approach, staging algorithm, bony and soft tissue reconstruction, and functional outcomes following surgery.

Method

We reviewed oncologic staging, surgical resections, and reconstructions of 45 consecutive patients undergoing spinopelvic resection with curative intent. Mean follow-up of surviving patients was 38 months. Common themes in these cases were identified to formulate the surgical classification.