Extended total sacrectomy and reconstruction for sacral tumor.

Norihide Ohata, Toshihumi Ozaki, Toshiyuki Kunisada, Yuki Morimoto, Masato Tanaka, Hajime Inoue

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

STUDY DESIGN: This case report includes the results of long-term follow-up after extended total sacrectomy in a 13-year-old boy with a sarcoma originating in the sacrum with an extraskeletal extension and infiltration into the left ilium. OBJECTIVE: To report and discuss a case of sacral tumor treated by extended sacrectomy. SUMMARY OF BACKGROUND DATA: Sacral tumors are often at an advanced stage with a large volume at diagnosis. Although total or extended sacrectomy is the only radical means to treat the massive sacral tumor, unavoidable complications in total sacrectomy are serious in the treatment selection. METHODS: Initial histologic findings indicated a synovial sarcoma. Additional genetic analysis redesignated the tumor as an unclassified sarcoma. Preoperative neoadjuvant chemotherapy and radiotherapy were completed. The response to the preoperative treatment appeared as a reduction in tumor size (approximately 50%) on radiographs. After extended sacrectomy, the L5 vertebral body was fixed between the ilia, and the pelvic ring was compressed by the Zielke system. The ISOLA instrumentation system connected the lumbar spine and both ilia. All sacral nerve roots and the L5 root on the left side were cut. RESULTS: At the 5-year follow-up examination, the patient was disease-free, could walk with crutches, and could climb stairs using the handrail and one crutch. CONCLUSIONS: The patient's excellent response to preoperative antitumor treatment was considered crucial to the long-term outcome. But the decision between a radical resection with reconstruction and a less extensive procedure with combined therapy remains controversial.

Original languageEnglish
JournalSpine
Volume29
Issue number6
Publication statusPublished - Mar 11 2004

Fingerprint

Ilium
Crutches
Neoplasms
Sarcoma
Synovial Sarcoma
Sacrum
Therapeutics
Spine
Radiotherapy
Drug Therapy

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Ohata, N., Ozaki, T., Kunisada, T., Morimoto, Y., Tanaka, M., & Inoue, H. (2004). Extended total sacrectomy and reconstruction for sacral tumor. Spine, 29(6).

Extended total sacrectomy and reconstruction for sacral tumor. / Ohata, Norihide; Ozaki, Toshihumi; Kunisada, Toshiyuki; Morimoto, Yuki; Tanaka, Masato; Inoue, Hajime.

In: Spine, Vol. 29, No. 6, 11.03.2004.

Research output: Contribution to journalArticle

Ohata, N, Ozaki, T, Kunisada, T, Morimoto, Y, Tanaka, M & Inoue, H 2004, 'Extended total sacrectomy and reconstruction for sacral tumor.', Spine, vol. 29, no. 6.
Ohata N, Ozaki T, Kunisada T, Morimoto Y, Tanaka M, Inoue H. Extended total sacrectomy and reconstruction for sacral tumor. Spine. 2004 Mar 11;29(6).
Ohata, Norihide ; Ozaki, Toshihumi ; Kunisada, Toshiyuki ; Morimoto, Yuki ; Tanaka, Masato ; Inoue, Hajime. / Extended total sacrectomy and reconstruction for sacral tumor. In: Spine. 2004 ; Vol. 29, No. 6.
@article{c9024371f4f444d89c33d1bab7185828,
title = "Extended total sacrectomy and reconstruction for sacral tumor.",
abstract = "STUDY DESIGN: This case report includes the results of long-term follow-up after extended total sacrectomy in a 13-year-old boy with a sarcoma originating in the sacrum with an extraskeletal extension and infiltration into the left ilium. OBJECTIVE: To report and discuss a case of sacral tumor treated by extended sacrectomy. SUMMARY OF BACKGROUND DATA: Sacral tumors are often at an advanced stage with a large volume at diagnosis. Although total or extended sacrectomy is the only radical means to treat the massive sacral tumor, unavoidable complications in total sacrectomy are serious in the treatment selection. METHODS: Initial histologic findings indicated a synovial sarcoma. Additional genetic analysis redesignated the tumor as an unclassified sarcoma. Preoperative neoadjuvant chemotherapy and radiotherapy were completed. The response to the preoperative treatment appeared as a reduction in tumor size (approximately 50{\%}) on radiographs. After extended sacrectomy, the L5 vertebral body was fixed between the ilia, and the pelvic ring was compressed by the Zielke system. The ISOLA instrumentation system connected the lumbar spine and both ilia. All sacral nerve roots and the L5 root on the left side were cut. RESULTS: At the 5-year follow-up examination, the patient was disease-free, could walk with crutches, and could climb stairs using the handrail and one crutch. CONCLUSIONS: The patient's excellent response to preoperative antitumor treatment was considered crucial to the long-term outcome. But the decision between a radical resection with reconstruction and a less extensive procedure with combined therapy remains controversial.",
author = "Norihide Ohata and Toshihumi Ozaki and Toshiyuki Kunisada and Yuki Morimoto and Masato Tanaka and Hajime Inoue",
year = "2004",
month = "3",
day = "11",
language = "English",
volume = "29",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Extended total sacrectomy and reconstruction for sacral tumor.

AU - Ohata, Norihide

AU - Ozaki, Toshihumi

AU - Kunisada, Toshiyuki

AU - Morimoto, Yuki

AU - Tanaka, Masato

AU - Inoue, Hajime

PY - 2004/3/11

Y1 - 2004/3/11

N2 - STUDY DESIGN: This case report includes the results of long-term follow-up after extended total sacrectomy in a 13-year-old boy with a sarcoma originating in the sacrum with an extraskeletal extension and infiltration into the left ilium. OBJECTIVE: To report and discuss a case of sacral tumor treated by extended sacrectomy. SUMMARY OF BACKGROUND DATA: Sacral tumors are often at an advanced stage with a large volume at diagnosis. Although total or extended sacrectomy is the only radical means to treat the massive sacral tumor, unavoidable complications in total sacrectomy are serious in the treatment selection. METHODS: Initial histologic findings indicated a synovial sarcoma. Additional genetic analysis redesignated the tumor as an unclassified sarcoma. Preoperative neoadjuvant chemotherapy and radiotherapy were completed. The response to the preoperative treatment appeared as a reduction in tumor size (approximately 50%) on radiographs. After extended sacrectomy, the L5 vertebral body was fixed between the ilia, and the pelvic ring was compressed by the Zielke system. The ISOLA instrumentation system connected the lumbar spine and both ilia. All sacral nerve roots and the L5 root on the left side were cut. RESULTS: At the 5-year follow-up examination, the patient was disease-free, could walk with crutches, and could climb stairs using the handrail and one crutch. CONCLUSIONS: The patient's excellent response to preoperative antitumor treatment was considered crucial to the long-term outcome. But the decision between a radical resection with reconstruction and a less extensive procedure with combined therapy remains controversial.

AB - STUDY DESIGN: This case report includes the results of long-term follow-up after extended total sacrectomy in a 13-year-old boy with a sarcoma originating in the sacrum with an extraskeletal extension and infiltration into the left ilium. OBJECTIVE: To report and discuss a case of sacral tumor treated by extended sacrectomy. SUMMARY OF BACKGROUND DATA: Sacral tumors are often at an advanced stage with a large volume at diagnosis. Although total or extended sacrectomy is the only radical means to treat the massive sacral tumor, unavoidable complications in total sacrectomy are serious in the treatment selection. METHODS: Initial histologic findings indicated a synovial sarcoma. Additional genetic analysis redesignated the tumor as an unclassified sarcoma. Preoperative neoadjuvant chemotherapy and radiotherapy were completed. The response to the preoperative treatment appeared as a reduction in tumor size (approximately 50%) on radiographs. After extended sacrectomy, the L5 vertebral body was fixed between the ilia, and the pelvic ring was compressed by the Zielke system. The ISOLA instrumentation system connected the lumbar spine and both ilia. All sacral nerve roots and the L5 root on the left side were cut. RESULTS: At the 5-year follow-up examination, the patient was disease-free, could walk with crutches, and could climb stairs using the handrail and one crutch. CONCLUSIONS: The patient's excellent response to preoperative antitumor treatment was considered crucial to the long-term outcome. But the decision between a radical resection with reconstruction and a less extensive procedure with combined therapy remains controversial.

UR - http://www.scopus.com/inward/record.url?scp=16644377295&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=16644377295&partnerID=8YFLogxK

M3 - Article

VL - 29

JO - Spine

JF - Spine

SN - 0362-2436

IS - 6

ER -