ABSTRACT
Emisacrectomy is a challenging surgery in the treatment of tumours that affect the sacrum. Authors report their experience in 11 cases affected by tumours of the sacrum (9 chordomas, 1 ependymoma, 1 monostotic bladder metastasis) operated on at the Orthopaedic Department of A.S.O S. Giovanni Battista Molinette in Turin, Italy, from 1998 through 2005 discussing planning surgery, level of osteotomy, functional and oncological results and complications of the treatment at a median follow-up of 5 years (range 2-9), describing the surgical and medical teaching learned from the treatment of these patients. Despite the potential complications, emisacrectomy can be performed successfully and is an important procedure in the treatment of sacral tumours.
Subject(s)
Bone Neoplasms/surgery , Neurosurgical Procedures/methods , Osteotomy/methods , Sacrum/surgery , Aged , Bone Neoplasms/pathology , Bone Neoplasms/secondary , Carcinoma/secondary , Carcinoma/surgery , Chordoma/diagnostic imaging , Chordoma/pathology , Chordoma/surgery , Ependymoma/diagnostic imaging , Ependymoma/pathology , Ependymoma/surgery , Female , Follow-Up Studies , Humans , Lumbosacral Plexus/pathology , Lumbosacral Plexus/surgery , Magnetic Resonance Imaging , Male , Middle Aged , Postoperative Complications/etiology , Postoperative Complications/pathology , Postoperative Complications/physiopathology , Preoperative Care , Radiography , Plastic Surgery Procedures/methods , Retrospective Studies , Sacrum/pathology , Time , Treatment Outcome , Urinary Bladder Neoplasms/pathologyABSTRACT
A case report of a 41-year-old man who had a delayed pharyngo-esophageal perforation without instrumentation failure 7 years after anterior cervical spine plating is presented and the literature on this issue is reviewed. This injury resulted from repetitive friction/traction between the retropharyngo-esophageal wall and the cervical plate construct leading to a pseudodiverticulum and perforation. Successful treatment of the perforation was obtained after surgical repair using a sternocleidomastoid muscle flap. This case stresses the necessity of careful long-term follow-up in patients with anterior cervical spine plating for early detection of possible perforation and the use of muscle flap as the treatment of choice during surgical repair.
