Primary pelvic sarcomas remain challenging and complex surgical problems with significant potential for postoperative impairment of ambulation, as well as bowel, bladder, and sexual function. En bloc resection with negative tumor margins represents the best chance of control or cure as current adjuvant therapies remain ineffective. Tumor involvement of the sacrum with extension to the greater sciatic notch and ipsilateral ilium requires an external hemipelvectomy and sagittal sacrectomy with sacrifice of the lower extremity to achieve en bloc resection, followed by lumbar-pelvic reconstruction. A patient with an iliosacral chondrosarcoma is presented to illustrate a novel lumbar-pelvic reconstruction technique, in which vascularized soft tissue and 2 vascularized bone grafts were harvested from the amputated lower extremity and transferred to the pelvis as composite flaps to restore pelvic ring integrity, augment lumbar-pelvic fusion, and close the soft-tissue defect. The biomechanical dynamics of this unique construct are discussed.
Address correspondence to: Ehud Mendel, M.D., Department of Neurosurgery, # N1037 Doan Hall, The Ohio State University Medical Center, 410 West 10th Avenue, Columbus, Ohio 43210. email: firstname.lastname@example.org.
Please include this information when citing this paper: published online April 22, 2011; DOI: 10.3171/2011.3.SPINE10569.
HsiehPC, , XuR, , SciubbaDM, , McGirtMJ, , NelsonC, & WithamTF, : Long-term clinical outcomes following en bloc resections for sacral chordomas and chondrosarcomas: a series of twenty consecutive patients. Spine (Phila Pa 1976)34:2233–2239, 2009
HsiehPC, XuR, SciubbaDM, McGirtMJ, NelsonC, WithamTF, : Long-term clinical outcomes following en bloc resections for sacral chordomas and chondrosarcomas: a series of twenty consecutive patients. Spine (Phila Pa 1976)34:2233–2239, 2009)| false