A 25-Year Experience with Hemicorporectomy for Terminal Pelvic Osteomyelitis

Abstract

Including this clinical series, a total of 66 hemicorporectomies have now been reported in the literature. Twenty cases were performed for terminal pelvic osteomyelitis with no mortality within 30 days of surgery, and 53.3 percent of patients were alive and well at long-term follow-up. Given the low perioperative mortality along with the ability of patients to achieve long-term survival following this operation, hemicorporectomy should be offered to appropriate patients suffering from terminal pelvic osteomyelitis.

Recurrent hospitalisations in a rare case of hemicorporectomy: a challenging case for medical management

“…Other case reports suggest that some hemicorporectomy patients can live multiple decades despite a grave preoperative diagnosis 12. A case series of one woman and eight men (all paraplegic) who underwent hemicorporectomy for terminal pelvic osteomyelitis between 1981 and 2005 found that for the four surviving patients at follow-up, none suffered recurrent decubitus ulcers (with a range of survival after surgery of 1.7–22 years) 5. For the patients who died, the cause of death was urosepsis for one patient, a fall for one patient, portal vein thrombosis for one patient and unknown cause for two patients.…”

“…Outcomes are generally more favourable for non-malignant versus malignant indications 4. For terminal pelvic osteomyelitis, more than 50% of patients survived at least 9 years, with an average survival of 11 years posthemicorporectomy 5. The average survival postprocedure decreases to 2.9 years when malignancy is the indication for hemicorporectomy 5.…”

“…For terminal pelvic osteomyelitis, more than 50% of patients survived at least 9 years, with an average survival of 11 years posthemicorporectomy 5. The average survival postprocedure decreases to 2.9 years when malignancy is the indication for hemicorporectomy 5. Overall, one-third of patients survived at least 9 years after hemicorporectomy 5…”

“…Although published reports suggest prolonged survival (>50% survival for terminal pelvic osteomyelitis at 9 years) posthemicorporectomy, this does not take into account the quality of life and morbidity of patients 5. In the postoperative period, complications of hemicorporectomy include volume overload, wound dehiscence and delayed healing 5.…”

“…In the postoperative period, complications of hemicorporectomy include volume overload, wound dehiscence and delayed healing 5. Some of the first patients to undergo this procedure died of pulmonary hypertension 6.…”