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  • Title: En bloc hemisacrectomy and internal hemipelvectomy via the posterior approach.
    Author: Clarke MJ, Zadnik PL, Groves ML, Dasenbrock HH, Sciubba DM, Hsu W, Witham TF, Bydon A, Gokaslan ZL, Wolinsky JP.
    Journal: J Neurosurg Spine; 2014 Sep; 21(3):458-67. PubMed ID: 24926933.
    Abstract:
    OBJECT: Traditionally, hemisacrectomy and internal hemipelvectomy procedures have required both an anterior and a posterior approach. A posterior-only approach has the potential to complete an en bloc tumor resection and spinopelvic reconstruction while reducing surgical morbidity. METHODS: The authors describe 3 cases in which en bloc resection of the hemisacrum and ilium and subsequent lumbopelvic and pelvic ring reconstruction were performed from a posterior-only approach. Two more traditional anterior and posterior staged procedures are also included for comparison. RESULTS: In all 3 cases, an oncologically appropriate surgery and spinopelvic reconstruction were performed through a posterior-only approach. CONCLUSIONS: The advantage of a midline posterior approach is the ability to perform a lumbosacral reconstruction, necessary in cases in which the S-1 body is iatrogenically disrupted during tumor resection.
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