Reconstruction after total en bloc sacrectomy for osteosarcoma using a custom-made prosthesis: a technical note.

摘要: STUDY DESIGN A report of an innovative technique to restore the lumbosacral junction after resection primary highly malignant osteosarcoma sacrum involving whole sacrum, soft tissues, and adjacent posterior parts both iliac wings. OBJECTIVES To describe planning design a custom-made sacral prosthesis, surgical technique, clinical functional outcome patient. SUMMARY OF BACKGROUND DATA Although there have been case reports about reconstruction methods total sacrectomy, date, has not reported successful using individual designed prosthesis based on three-dimensional real-sized model. METHODS 42-year-old woman was referred with progressive neurologic impairment due invading surrounding structures. Based model, detailed plan developed assure safe, wide margins. In addition, model enabled testing provide stable reconstruction. RESULTS After induction chemotherapy, staged anteroposterior resection-reconstruction successfully performed. surgery, superficial wound dehiscence promptly treated. Within 3 weeks mobilization began, adjuvant chemotherapy continued. At 36-month follow-up, patient disease free, had stable, painless spinopelvic junction, could walk short distances ankle orthoses crutches. Radiographs show complete incorporation pelvic grafts unchanged position implant. CONCLUSIONS performing including substantial wings, offers surgeons distinct advantages. Wide bony margins can be drawn re-establish continuity tested before intervention.