Hemisacrectomy with preservation of the contralateral sacral nerve roots and sacroiliac joint for pelvic neurofibrosarcoma in a 7-year-old child: case report with 2-year follow-up

Abstract

<jats:p>Neurofibrosarcoma is rare in the pediatric age group. A malignant tumor of the sacrum presents significant challenges, especially if the goals are to resect with wide and clean surgical margins and to achieve acceptable functional outcomes. The authors report a case of this rare tumor affecting the sacrum and sacral nerve roots of a 7-year-old girl and review the role of total hemisacrectomy sparing the contralateral sacral nerve roots and lumbopelvic reconstruction in the treatment of this disease. This patient is, to the best of the authors' knowledge, the youngest to be treated in this manner.</jats:p>

Reconstruction after hemisacrectomy with a novel 3D-printed modular hemisacrum implant in sacral giant cell tumor of the bone

“…To the best of our knowledge, the use of a custom 3D-printed sacral prosthesis for lumbosacral reconstruction is extremely rare ( Houdek et al, 2020 ). Spinal–pelvic reconstruction after hemisacrectomy is a challenging and high-risk task ( Palejwala et al, 2017 ). In recent years, 3D printing technology has been successfully applied to preoperative planning, resection, and reconstruction of bone tumor surgery, opening up new routes for reconstruction after the resection of bone tumors in complex sites ( Habib et al, 2022 ).…”

“…Vertical resection of the tumor in half of the sacrum disrupts the spinal–pelvic continuity and requires reconstruction to restore bony connections and mechanical transmission ( Clarke et al, 2014 ; Reynolds et al, 2016 ). Tumors involving half of the sacrum are rare, and standard protocols for resection and reconstruction are lacking ( Palejwala et al, 2017 ). Spine–pelvis reconstruction usually relies on various forms of internal fixation, such as nail rods, titanium mesh, and long bone segment bone graft; however, due to the small contact area and limited three-dimensional configuration, it is difficult to meet the requirements ( Bederman et al, 2014 ).…”