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00152232-200910003-00065AbstractSpine: Affiliated Society Meeting AbstractsSpine: Affiliated Society Meeting Abstracts© 2009 Lippincott Williams & Wilkins, Inc.10September 2009 p 99–100Classification of Spinopelvic Resections: Oncologic and Reconstructive ImplicationsPaper #65Scientific Program AbstractsYaszemski, Michael J. MD, PhD (Mayo Clinic); Rose, Peter S. MD; Currier, Bradford L. MD; Dekutoski, Mark B. MD; Huddleston, Paul M. MD; Nassr, Ahmad MD; Pichelman, Mark A. MD; Sim, Franklin H. MDLevel of Evidence: IVIntroduction: Curative treatment of malignancies in the sacrum and lower lumbar spine frequently requires en bloc spinopelvic resection. There is no standard classification of these procedures. We present outcomes and a classification scheme with oncologic and reconstructive guidelines for spinopelvic tumors based on an analysis of 30 cases.Methods: We reviewed oncologic staging, surgical resections, and reconstructions of 30 patients presenting with malignant tumors undergoing spinopelvic resection with curative intent. Mean follow-up of surviving patients was 38 months.Results: Tumors included osteosarcoma (n=9), chondrosarcoma (n=6), chordoma (n=5), other sarcomas (n=5), neurogenic tumors (n=4), and local extension of carcinoma (n=1). We classify resections into 4 types. Type 1 resections included a total sacrectomy with lower lumbar spine and bilateral medial iliac resections. Type 2 resections included hemisacrectomy, partial lumbar spine excision, and iliac wing resection. Type 3 resections encompassed external hemipelvectomy with hemisacrectomy and partial excision of one or more lumbar vertebrae. Type 4 resections encompassed external hemipelvectomy, total sacrectomy, with or without lumbar vertebrectomies, and with or without partial iliac resection on the remaining side. For each resection type, we have developed staged surgical approaches to allow resection with wide margins and reconstruction of spinopelvic continuity. Tumor free margins were achieved in all cases. Perioperative mortality was 3/30. Ten additional patients have died of disease, 2 died of other causes, 2 are alive with disease, and 16 have no evidence of disease. 13/18 surviving patients are independent in their activities of daily living.Conclusion: En bloc excision and reconstruction of spinopelvic neoplasms may be classified into four types. For each type, we have devised surgical treatment guidelines to allow for wide resection and reconstruction of spinopelvic continuity. Long term survival and independent function can be achieved in this challenging patient population.Significance: This represents the first standardized classification of oncologic spinopelvic resections and reconstructions.JOURNAL/spinea/04.03/00152232-200910003-00065/table1-65/v/2021-02-17T195448Z/r/image-jpegno caption available.<strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">Classification of Spinopelvic Resections: Oncologic and Reconstructive Implications</strong>: <strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">Paper #65</strong>Yaszemski Michael J. MD PhD (Mayo Clinic); Rose, Peter S. MD; Currier, Bradford L. MD; Dekutoski, Mark B. MD; Huddleston, Paul M. MD; Nassr, Ahmad MD; Pichelman, Mark A. MD; Sim, Franklin H. MDScientific Program AbstractsScientific Program Abstracts10p 99-100