Author/Authors :
Pedro FreiTas araújo, Thiego institute of Orthopedics and Traumatology - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), São Paulo, SP, Brazil , Kenji narazaKi, douglas Spine Surgery Division - Tumors of the Vertebral Spine - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), São Paulo, SP, Brazil , gemio jacobsen Teixeira, William Spine Surgery Division - Tumors of the Vertebral Spine - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), São Paulo, SP, Brazil , busnardo, Fábio Surgery Division - Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil , Fogaça crisTanTe, alexandre Medical Investigations Laboratory - Spine Surgery Division - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), São Paulo, SP, Brazil , eloy Pessoa de barros Filho, Tarcísio Medical Investigations Laboratory - Spine Surgery Division - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), São Paulo, SP, Brazil
Abstract :
Objective: The purpose of this study was to demonstrate, in a case
series, a new sacrectomy technique using an iliac crest dowel
graft from a cadaver. Study design: Report of a case series with
description of a new surgical technique. Methods: The technique
uses four bars to support the posterior spine and a dowel graft in
the iliac wings, with compression of the spine and pelvis above it,
to support the anterior spine. Three cases were operated on, and
in all of them, a vertebrectomy was used. Results: In the first two
cases, the technique was performed as a two-stage surgery. The
first stage was performed via the anterior and peritoneal access
routes, and the second stage via the posterior access route. In
the third case, retroperitoneal access via the anterior route meant
that the technique could be performed in one stage, resulting in an
overall reduction in surgical time (1250 vs. 1750 vs. 990 minutes,
respectively). Conclusion: The new technique enables fixation with
biomechanical stability, which is essential to support the stress
in the lumbosacral transition and promote earlier rehabilitation.
Level of evidence IV, case series.
Keywords :
Spine , Cadaver , Lumbosacral Region , Bone neoplasms