Radical excision of malignant sacral tumors using a modified threadwire saw.

摘要

BACKGROUND: Surgical treatment of malignant sacral tumors is difficult, and has a high rate of recurrence. OBJECTIVES: The aim of this study was to examine the wide margin of large and small malignant sacral tumors using a threadwire saw (T-saw). MATERIALS AND METHODS: We devised a flexible silver guide probe connected to a modified threadwire saw by a suture thread to perform osteotomies. We operated on 10 patients with sacral tumors using this device. The sacral excisions were performed via a posterior approach by four surgeons (two on each side) working simultaneously. RESULTS: We obtained a wide margin in all cases and no recurrence, after a mean follow-up of 4 years 2 months (range, 1 year 8 months-7 years 8 months). In one case, one nerve root on the right side was injured. CONCLUSIONS: Our new method is easier and faster than the conventional method in cases in which bilateral sacral nerve root canals require sectioning, and it produces a wide tumor margin.