PURPOSE: To study the oncological and functional outcomes of patients undergoing en bloc tumor excisions and neuroanastomosis for sacral tumors. METHODS: Five patients who underwent en bloc total sacrectomy and neuroanastomosis from January 2006 to August 2010 were observed. A procedure combining the anterior and posterior approach was used on these patients. Neuroanastomosis was performed after sacrectomy. Perioperative complications and postoperative functions in these patients were analyzed. RESULTS: All patients had partial or complete loss of bladder and bowel functions, foot plantar flexion weakness and increased residual urine volume after surgery. Three patients were ambulatory. After 6 months, four patients were disease-free, two patients reported slightly improved bladder and bowel functions, four patients could ambulate with a walking stick and the one patient with sarcoma had other metastases and died after 8 months. After 1 year, two patients reported improved bladder and bowel functions, one patient slightly improved bladder and bowel functions and there was no change in one patient. CONCLUSION: Successful neuroanastomosis of sacral nerve roots does not occur in all patients, but lower limb, bladder and bowel functions can improve with time after the surgery.
PURPOSE: To study the oncological and functional outcomes of patients undergoing en bloc tumor excisions and neuroanastomosis for sacral tumors. METHODS: Five patients who underwent en bloc total sacrectomy and neuroanastomosis from January 2006 to August 2010 were observed. A procedure combining the anterior and posterior approach was used on these patients. Neuroanastomosis was performed after sacrectomy. Perioperative complications and postoperative functions in these patients were analyzed. RESULTS: All patients had partial or complete loss of bladder and bowel functions, foot plantar flexion weakness and increased residual urine volume after surgery. Three patients were ambulatory. After 6 months, four patients were disease-free, two patients reported slightly improved bladder and bowel functions, four patients could ambulate with a walking stick and the one patient with sarcoma had other metastases and died after 8 months. After 1 year, two patients reported improved bladder and bowel functions, one patient slightly improved bladder and bowel functions and there was no change in one patient. CONCLUSION: Successful neuroanastomosis of sacral nerve roots does not occur in all patients, but lower limb, bladder and bowel functions can improve with time after the surgery.
Authors: R Shane Tubbs; James W Custis; E George Salter; Jeffrey P Blount; W Jerry Oakes; John C Wellons Journal: J Neurosurg Date: 2006-05 Impact factor: 5.115