Spinopelvic Reconstruction with Femoral Allograft and Vertical Rectus Abdominis Myocutaneous Flap after Total Sacrectomy in Recurrent Sacral Chordoma: A Case Report

STUDY DESIGN: Case report. OBJECTIVES: To report a case of recurrent sacral chordoma treated with total sacrectomy and spinopelvic reconstruction. SUMMARY OF LITERATURE REVIEW: Sacral chordoma is a musculoskeletal tumor reported to have a low incidence. Surgical treatment is considered difficult due to the complicated sacropelvic structure, so the prognosis for patients with sacral chordoma has been considered poor. MATERIALS AND METHODS: We report a surgical technique and outcomes from spinopelvic reconstruction with femoral allograft and vertical rectus abdominis myocutaneous flap after total sacrectomy. RESULTS: We report no tumor recurrence at 43 months postoperatively. CONCLUSIONS: Spinopelvic reconstruction with thorough surgical planning after total sacrectomy was found to be a safe and effective treatment method.

Management of Sacral Tumors Requiring Spino-Pelvic Reconstruction with Different Histopathologic Diagnosis: Evaluation with Four Cases

In this retrospective study, surgical results of four patients with sacral tumors having disparate pathologic diagnoses, who were treated with partial or total sacrectomy and lumbopelvic stabilization were abstracted. Two patients were treated with partial sacral resection and two patients were treated with total sacrectomy and spinopelvic fixation. Fixation methods included spinopelvic fixation with rods and screws in two cases, reconstruction plate in one case, and fresh frozen allografts in two cases. Fibular allografts used for reconstruction accelerated bony union and enhanced the stability in two cases. Addition of polymethyl methacrylate in the cavity in the case of a giant cell tumor had a positive stabilizing effect on fixation. As a result, we can conclude that mechanical instability after sacral resection can be stabilized securely with lumbopelvic fixation and polymethyl methacrylate application or addition of fresh frozen allografts between the rods can augment the stability of the reconstruction.