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Midsacral Amputation for En Bloc Resection of Chordoma

Rao, Ganesh MD; Chang, George J. MD, MS; Suk, Ian BSc, BMC; Gokaslan, Ziya MD; Rhines, Laurence D. MD

doi: 10.1227/01.NEU.0000365799.21610.C4
Spine: Surgical Technique

BACKGROUND: En bloc resection, with adequate surgical margins, of primary malignant bone tumors of the sacrum is associated with long term disease control and potential cure. Resection of sacral tumors is difficult due to the proximity of neurovascular and visceral structures, and complete, or even partial, sacrectomy often results in functional loss for the patient.

OBJECTIVE: We describe the technique for en bloc resection of a sacral chordoma through a mid-sacral amputation.

RESULTS: We demonstrate successful removal of a large sacral tumor with wide surgical margins while preserving neurologic function.

CONCLUSION: This technique for midsacral amputation to remove a sacral tumor en bloc minimizes local recurrence and maximizes neurovascular function.

Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas (Rao) (Rhines)

Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas (Chang)

Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland (Suk) (Gokaslan)

Reprint requests: Laurence D. Rhines, MD, Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 442, Houston, TX 77030. E-mail: lrhines@mdanderson.org

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Received, August 14, 2009.

Accepted, November 10, 2009.

Copyright © by the Congress of Neurological Surgeons