The extended posterior approach for resection of sacral tumours

S. P. Mohanty, Madhava Pai Kanhangad, Raghuraj Kundangar

Research output: Contribution to journalArticle

Abstract

Purpose: The conventional posterior approach is mostly advocated for excision of sacral tumours below S2. We describe an operative technique of single-stage en bloc resection of sacral tumours, extending up to S1, through an extended posterior approach. Method: Nine patients, who had undergone resection of sacral tumours, by the described technique formed the basis of this study. Four patients had chordomas, whereas schwannoma, neurilemmoma, giant-cell tumour, malignant paraganglioma and recurrent Ewing’s sarcoma were seen in one patient each. They were followed up at regular intervals with a mean follow-up of 45.4 months. Perioperative complications, their functional and oncological outcomes at final follow-up were analysed. Result: None of the patients had any perioperative complications like uncontrolled haemorrhage, injury to the rectum, deep vein thrombosis or pulmonary embolism. One patient had a superficial wound infection which subsided with regular dressing, and another patient developed a wound breakdown that required an additional flap procedure. At final follow-up, six patients were able to walk without any assistive devices, six patients had normal bladder function, and five patients had normal bowel function. Five patients did not have any recurrence at final follow-up, whereas two were alive with the disease and two had died. Conclusion: The reported technique allows en bloc resection of sacral tumours up to S1, through a posterior-only approach. It is less invasive with minimal morbidity. The functional and oncological outcomes are similar to those reported by other investigators. Graphical abstract: These slides can be retrieved from electronic supplementary material.[Figure not available: see fulltext.].

Original languageEnglish
Pages (from-to)1461-1467
Number of pages7
JournalEuropean Spine Journal
Volume28
Issue number6
DOIs
Publication statusPublished - 01-06-2019

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Neoplasms
Neurilemmoma
Chordoma
Self-Help Devices
Giant Cell Tumors
Paraganglioma
Ewing's Sarcoma
Wounds and Injuries
Wound Infection
Bandages
Pulmonary Embolism
Rectum
Venous Thrombosis
Urinary Bladder
Research Personnel
Hemorrhage
Morbidity
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Mohanty, S. P. ; Pai Kanhangad, Madhava ; Kundangar, Raghuraj. / The extended posterior approach for resection of sacral tumours. In: European Spine Journal. 2019 ; Vol. 28, No. 6. pp. 1461-1467.
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abstract = "Purpose: The conventional posterior approach is mostly advocated for excision of sacral tumours below S2. We describe an operative technique of single-stage en bloc resection of sacral tumours, extending up to S1, through an extended posterior approach. Method: Nine patients, who had undergone resection of sacral tumours, by the described technique formed the basis of this study. Four patients had chordomas, whereas schwannoma, neurilemmoma, giant-cell tumour, malignant paraganglioma and recurrent Ewing’s sarcoma were seen in one patient each. They were followed up at regular intervals with a mean follow-up of 45.4 months. Perioperative complications, their functional and oncological outcomes at final follow-up were analysed. Result: None of the patients had any perioperative complications like uncontrolled haemorrhage, injury to the rectum, deep vein thrombosis or pulmonary embolism. One patient had a superficial wound infection which subsided with regular dressing, and another patient developed a wound breakdown that required an additional flap procedure. At final follow-up, six patients were able to walk without any assistive devices, six patients had normal bladder function, and five patients had normal bowel function. Five patients did not have any recurrence at final follow-up, whereas two were alive with the disease and two had died. Conclusion: The reported technique allows en bloc resection of sacral tumours up to S1, through a posterior-only approach. It is less invasive with minimal morbidity. The functional and oncological outcomes are similar to those reported by other investigators. Graphical abstract: These slides can be retrieved from electronic supplementary material.[Figure not available: see fulltext.].",
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Mohanty, SP, Pai Kanhangad, M & Kundangar, R 2019, 'The extended posterior approach for resection of sacral tumours', European Spine Journal, vol. 28, no. 6, pp. 1461-1467. https://doi.org/10.1007/s00586-018-5834-3

The extended posterior approach for resection of sacral tumours. / Mohanty, S. P.; Pai Kanhangad, Madhava; Kundangar, Raghuraj.

In: European Spine Journal, Vol. 28, No. 6, 01.06.2019, p. 1461-1467.

Research output: Contribution to journalArticle

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N2 - Purpose: The conventional posterior approach is mostly advocated for excision of sacral tumours below S2. We describe an operative technique of single-stage en bloc resection of sacral tumours, extending up to S1, through an extended posterior approach. Method: Nine patients, who had undergone resection of sacral tumours, by the described technique formed the basis of this study. Four patients had chordomas, whereas schwannoma, neurilemmoma, giant-cell tumour, malignant paraganglioma and recurrent Ewing’s sarcoma were seen in one patient each. They were followed up at regular intervals with a mean follow-up of 45.4 months. Perioperative complications, their functional and oncological outcomes at final follow-up were analysed. Result: None of the patients had any perioperative complications like uncontrolled haemorrhage, injury to the rectum, deep vein thrombosis or pulmonary embolism. One patient had a superficial wound infection which subsided with regular dressing, and another patient developed a wound breakdown that required an additional flap procedure. At final follow-up, six patients were able to walk without any assistive devices, six patients had normal bladder function, and five patients had normal bowel function. Five patients did not have any recurrence at final follow-up, whereas two were alive with the disease and two had died. Conclusion: The reported technique allows en bloc resection of sacral tumours up to S1, through a posterior-only approach. It is less invasive with minimal morbidity. The functional and oncological outcomes are similar to those reported by other investigators. Graphical abstract: These slides can be retrieved from electronic supplementary material.[Figure not available: see fulltext.].

AB - Purpose: The conventional posterior approach is mostly advocated for excision of sacral tumours below S2. We describe an operative technique of single-stage en bloc resection of sacral tumours, extending up to S1, through an extended posterior approach. Method: Nine patients, who had undergone resection of sacral tumours, by the described technique formed the basis of this study. Four patients had chordomas, whereas schwannoma, neurilemmoma, giant-cell tumour, malignant paraganglioma and recurrent Ewing’s sarcoma were seen in one patient each. They were followed up at regular intervals with a mean follow-up of 45.4 months. Perioperative complications, their functional and oncological outcomes at final follow-up were analysed. Result: None of the patients had any perioperative complications like uncontrolled haemorrhage, injury to the rectum, deep vein thrombosis or pulmonary embolism. One patient had a superficial wound infection which subsided with regular dressing, and another patient developed a wound breakdown that required an additional flap procedure. At final follow-up, six patients were able to walk without any assistive devices, six patients had normal bladder function, and five patients had normal bowel function. Five patients did not have any recurrence at final follow-up, whereas two were alive with the disease and two had died. Conclusion: The reported technique allows en bloc resection of sacral tumours up to S1, through a posterior-only approach. It is less invasive with minimal morbidity. The functional and oncological outcomes are similar to those reported by other investigators. Graphical abstract: These slides can be retrieved from electronic supplementary material.[Figure not available: see fulltext.].

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