Biomechanical Effects of Transverse Partial Sacrectomy on the Sacroiliac Joints

Yu, Bo; Zheng, Zhaomin; Zhuang, Xiaoxi; Chen, Hui; Xie, Denghui; Luk, K.D.K.; Lu, William W.

doi:10.1097/brs.0b013e3181a3d440

Cited by 29 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 13 Two patients in our series required lumbopelvic fixation in a delayed fashion. Early biomechanical studies by Gunterberg 38 and others 39 , 40 have shown that lumbopelvic stabilization should be strongly considered after sacral amputations extending above the S1-2 junction. The 2 patients in our series who required lumbopelvic fixation both had high sacral amputations at the S1-2 junction and were left with a thin isthmus.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Zuckerman

Lee

Chang

et al. 2021

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Retrospective case series. Objective: To determine predictive factors of overall survival (OS) and local recurrence (LR), report complications, and assess the impact of complications on survival, recurrence, and function in patients undergoing en bloc resection of sacral chordoma. Methods: This retrospective case series was obtained from a prospective database (1995-2016). All patients underwent en bloc resection of sacral chordoma. Demographic, perioperative, and complication data were collected. Outcomes included: overall survival(OS), local recurrence(LR), and complications. Survival analysis with multivariable cox regression was performed. Results: Among 50 patients, median follow-up was 5.3 years (range = 1.3-17.2). The majority (82%) underwent a negative margin resection. Survival: 17 patients died (34%) with a median OS of 10.0 years (range = 1.3-17.2). Multivariable cox regression revealed that a negative margin resection was not significantly associated with improved survival (HR = 3.35, 95%CI 0.87-12.80, P = .078). Recurrence: 20 patients (40%) experienced LR with a median time of 6.2 years (range = 0-16.9). Multivariable cox regression revealed that a negative margin resection was associated with a significant decreased risk of LR (HR = 4.96, 95%CI 1.84-13.34, P = 0.002,). A 62% overall complication rate was seen (42% major), with 26% reoperation rate. Of the reoperations, 54% were delayed (>6 weeks after the index surgery). Multivariable cox regression demonstrated that neither major complication nor reoperation significantly impacted OS (HR = 0.62, 95%CI 0.22-1.79, P = 0.380), LR (HR = 1.28, 95%CI 0.49-3.36, P = 0.611), or functional outcomes (OR = 2.94, 95%CI 0.25-34.8, P = 0.393). Conclusions: Negative margin resection was associated with decreased LR. Neither major complication nor reoperation significantly impacted OS, LR, or functional outcome. Though additional studies are needed, it appears that despite the morbidity associated with sacral chordoma resection, the long-term clinical outcomes are favorable.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Zuckerman

Lee

Chang

et al. 2021

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…A wide variety of techniques have been suggested in pelvic reconstruction after sacrectomy. 7 8 Although pelvic reconstruction is challenging because of anatomical complexity and excessive weight bearing, optimal methods have not yet been developed because of the rarity of sacral lesions. Because there are no ready-made implants, various grafts have been used despite donor site complications.…”

Section: Discussionmentioning

confidence: 99%

Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result

et al. 2017

View full text Add to dashboard Cite

Pelvic reconstruction after sacral resection is challenging in terms of anatomical complexity, excessive loadbearing, and wide defects. Nevertheless, the technological development of 3D-printed implants enables us to overcome these difficulties. Here, we present a case of sacral osteosarcoma surgically treated with hemisacrectomy and sacral reconstruction using a 3D-printed implant. The implant was printed as a customized titanium prosthesis from a 3D real-sized reconstruction of a patient's CT images. It consisted mostly of a porous mesh and incorporated a dense strut. After 3-months of neoadjuvant chemotherapy, the patient underwent hemisacretomy with preservation of contralateral sacral nerves. The implant was anatomically installed on the defect and fixed with a screw-rod system up to the level of L3. Postoperative pain was significantly low and the patient recovered sufficiently to walk as early as 2 weeks postoperatively. The patient showed left-side foot drop only, without loss of sphincter function. In 1-year follow-up CT, excellent bony fusion was noticed. To our knowledge, this is the first report of a case of hemisacral reconstruction using a custom-made 3D-printed implant. We believe that this technique can be applied to spinal reconstructions after a partial or complete spondylectomy in a wide variety of spinal diseases.

show abstract

“…Other studies have applied offset compression to induce bending 24,25. A few studies have included pure moments in conjunction with follower loads to analyze the motion of the SI joint 26–28. The use of a follower load is thought to stabilize the spine, although its appropriateness is debated.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a minimally invasive procedure for sacroiliac joint fusion – an in vitro biomechanical analysis of initial and cycled properties

Lindsey¹,

Pérez-Orribo²,

Rodriguez-Martinez³

et al. 2014

MDER

View full text Add to dashboard Cite

IntroductionSacroiliac (SI) joint pain has become a recognized factor in low back pain. The purpose of this study was to investigate the effect of a minimally invasive surgical SI joint fusion procedure on the in vitro biomechanics of the SI joint before and after cyclic loading.MethodsSeven cadaveric specimens were tested under the following conditions: intact, posterior ligaments (PL) and pubic symphysis (PS) cut, treated (three implants placed), and after 5,000 cycles of flexion–extension. The range of motion (ROM) in flexion–extension, lateral bending, and axial rotation was determined with an applied 7.5 N · m moment using an optoelectronic system. Results for each ROM were compared using a repeated measures analysis of variance (ANOVA) with a Holm–Šidák post-hoc test.ResultsPlacement of three fusion devices decreased the flexion–extension ROM. Lateral bending and axial rotation were not significantly altered. All PL/PS cut and post-cyclic ROMs were larger than in the intact condition. The 5,000 cycles of flexion–extension did not lead to a significant increase in any ROMs.DiscussionIn the current model, placement of three 7.0 mm iFuse Implants significantly decreased the flexion–extension ROM. Joint ROM was not increased by 5,000 flexion–extension cycles.

show abstract

Biomechanical Effects of Transverse Partial Sacrectomy on the Sacroiliac Joints

Cited by 29 publications

References 15 publications

Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result

Evaluation of a minimally invasive procedure for sacroiliac joint fusion – an in vitro biomechanical analysis of initial and cycled properties

Contact Info

Product

Resources

About

Biomechanical Effects of Transverse Partial Sacrectomy on the Sacroiliac Joints

Cited by 29 publications

References 15 publications

Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result

Evaluation of a minimally invasive procedure for sacroiliac joint fusion &ndash; an in vitro biomechanical analysis of initial and cycled properties

Contact Info

Product

Resources

About

Evaluation of a minimally invasive procedure for sacroiliac joint fusion – an in vitro biomechanical analysis of initial and cycled properties