Background: Sacral tumors present a significant challenge to the spine surgeon. As new techniques have evolved in recent years, these lesions have become more amenable to aggressive surgical treatment. Although sacral tumors make up only a small minority of spinal tumors, their surgical management warrants special consideration.
Methods: Based on our experience, we highlight 3 important surgical nuances specifically for the treatment of sacral tumors: preservation and maximization of neurologic function, protection of ventral abdominal and pelvic structures, and lumbopelvic fixation.
Results: Two cases of patients with sacral tumors treated at our institution are presented to illustrate these points. Both patients had successful postoperative courses, and remained pain free, well-fixated, and neurologically intact at 3-4 month follow-up. They had no evidence of biomechanical instability.
Conclusions: To ensure a successful outcome, a goal-directed, methodical approach is required.
Keywords: Sacral lesions; Sacral tumor; Sacrectomy; Sacrum; Spinopelvic stability.
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