High Long-term Local Control with Sacrectomy for Primary High-grade Bone Sarcoma in Children

Abstract

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

What Are the Functional Outcomes After Total Sacrectomy Without Spinopelvic Reconstruction?

“…Some studies reported results for the whole patients and included both patients undergoing total sacrectomy and those undergoing partial sacrectomy, in whom functional results should be different [1,21,28]. For series of total sacrectomy with reconstruction [1-3, 5, 6, 12, 18, 20, 23-25, 28], the proportions of patients who were able to ambulate with walking aids varied widely (Table 3).…”

“…Because of the instability and discontinuity between the lumbar spine and pelvis, most surgeons perform spinopelvic reconstruction to facilitate early mobilization and better ambulation [1,3,5,6,10,16,18,20,23,25,28]. However, some surgeons prefer not to perform bony reconstructions after sacrectomy because some patients can ambulate and to avoid the risk of implant-related complications [11,19,21,22].…”

“…We therefore asked: (1) What is the functional outcome and ambulatory status of patients after total sacrectomy without spinopelvic reconstruction? (2) What is the walking ability and ambulatory status of patients when categorized by the location of the iliosacral resection relative to the sacroiliac joint?…”

Computer-Assisted Navigation During an Anterior-Posterior En Bloc Resection of a Sacral Tumor

“…A multi-modality IONM was used including somatosensory evoked potentials (SSEP), transcranial electrical motor evoked potentials (TCeMEP), and electromyography (EMG). IONM was helpful during this surgery in guiding the surgical team and in preventing any damage to sacral roots on the normal right side and preventing any positional neurapraxia in upper extremities [ 5 - 6 ].…”

Modern surgical techniques for management of soft tissue sarcomas involving the spine: Outcomes and complications

“…The ideal management of patients with Ewing's sarcomas usually involves multimodal therapies. Several studies have shown that en‐bloc resection provides the best chances of long‐term disease‐free survival . However, a recent systematic review has suggested that despite en bloc surgical resection providing improved local control, is does not necessarily improve overall survival for patients with spinal Ewing's sarcomas .…”