The first experience of total sacral endoprothesis with an individual implant after total sacrectomy (a rare clinical case)
https://doi.org/10.17650/2219-4614-2025-17-1-91-98
Abstract
Bone sarcomas are one the rarest types of malignant tumors comprising only 0.2–1 % of oncological diseases. Chondrosarcoma is the 3rd most common bone sarcoma. This tumor is characterized by low sensitivity to drug and radiological treatment. According to literature data, the current golden standard of bone chondrosarcoma treatment is en bloc radical surgical resection with preservation of clean resection margins. However, common for this tumor location in the pelvic bones can pose difficulties at the stage of surgical planning.
The article presents a clinical case of surgical treatment of sacrum G2 chondrosarcoma in the volume of total sacrectomy with defect replacement using a personalized implant manufactured using a 3D printer and with lumbosacral stabilization.
Keywords
About the Authors
D. I. SofronovRussian Federation
Denis Igorevich Sofronov
24 Kashirskoe Shosse, Moscow 115522
K. N. Magomedova
Russian Federation
2/1 Barrikadnaya St., 123995 Moscow
O. Efimenko
Russian Federation
6 Novatorov St., Moscow 117393
K. A. Borzov
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
A. V. Fedorova
Russian Federation
24 Kashirskoe Shosse, Moscow 115522; 5 Revolyucionnaya St., Yaroslavl 150000
R. M. Kabardaev
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
A. M. Galustov
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
A. R. Shin
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
A. V. Sytov
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
A. K. Valiev
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
References
1. Zileli M., Hoscoskun C., Brastianos P., Sabah D. Surgical treatment of primary sacral tumors: complications associated with sacrectomy. Neurosurg Focus 2003;15(5):E9.
2. Stuckey R.M., Marco R.A. Marco Chondrosarcoma of the mobile spine and sacrum. Sarcoma 2011;2011:274281. DOI: 10.1155/2011/274281
3. Boriani S., De Lure F., Bandiera S. et al. Chondrosarcoma of the mobile spine: report on 22 cases. Spine 2000;25(7):804–12. DOI: 10.1097/00007632-200004010-00008
4. Shives T.C., McLeod R.A., Unni K.K., Schray M.F. Chondrosarcoma of the spine. J Bone Joint Surg Am 1989;71(8):1158–65.
5. Gitelis S., Bertoni F., Picci P., Campanacci M. Chondrosarcoma of bone. The experience at the Istituto Ortopedico Rizzoli. J Bone Joint Surg Am 1981;63(8):1248–57.
6. Arshi A., Sharim J., Park D.Y. et al. Chondrosarcoma of the osseous spine. An analysis of epidemiology, patient outcomes, and prognostic factors using the SEER registry from 1973 to 2012. Spine (Phila Pa 1976) 2017;42:644–52. DOI: 10.1097/BRS.0000000000001870
7. Varga P.P., Bors I., Lazary A. Sacral tumors and management. Orthop Clin North Am 2009;40:105–23. DOI: 10.1016/j.ocl.2008.09.010
8. Zang J., Guo W., Yang R. et al. Is total en bloc sacrectomy using a posterior-only approach feasible and safe for patients with malignant sacral tumors? J Neurosurg Spine 2015;22(6):563–70. DOI: 10.3171/2015.1.SPINE14237
9. Nishizawa K., Mori K., Saruhashi Y. Long-term clinical outcome of sacral chondrosarcoma treated by total en bloc sacrectomy and reconstruction of lumbosacral and pelvic ring using intraoperative extracorporeal irradiated autologous tumor-bearing sacrum: a case report with 10 years follow-up. Spine J 2014;14(5):e1–8. DOI: 10.1016/j.spinee.2013.10.057
10. Newman C.B., Keshavarzi S., Aryan H.E. En bloc sacrectomy and reconstruction: technique modification for pelvic fixation. Surg Neurol 2009:72(6):752–6. DOI: 10.1016/j.surneu.2009.02.008
11. Fourney D.R., Rhines L.D., Hentschel S.J. et al. En bloc resection of primary sacral tumors: classification of surgical approaches and out-come. J Neurosurg Spine 2005;3(2):111–22. DOI: 10.3171/spi.2005.3.2.0111
12. Gokaslan Z.L., Romsdahl M.M., Kroll S.S. et al. Total sacrectomy and Galveston L-rod reconstruction for malignant neoplasms. Technical note. J Neurosurg 1997;87(5):781–7. DOI: 10.3171/jns.1997.87.5.0781
13. Nassif N.A., Buchowski J.M., Osterman K., McDonald D.J. Surgical technique: iliosacral reconstruction with minimal spinal instrumentation. Clin Orthop Relat Res 2913;471(3):947–55. DOI: 10.1007/s11999-012-2643-6
14. Ogura K., Sakuraba M., Miyamoto S. et al. Pelvic ring reconstruction with a double-barreled free vascularized fibula graft after resection of malignant pelvic bone tumor. Arch Orthop Trauma Surg 2015;135(5):619–25. DOI: 10.1007/s00402-015-2197-7
15. Lin P., Shao Y., Lu H. et al. Pelvic reconstruction with different rod-screw systems following Enneking type I/I + IV resection: a clinical study. Oncotarget 2017;8(24):38978–89. DOI: 10.18632/oncotarget.17164
16. Sabourin M., Biau D., Babinet A. et al. Surgical management of pelvic primary bone tumors involving the sacroiliac joint. Orthop Traumatol Surg Res 2009;95(4):–92. DOI: 10.1016/j.otsr.2009.04.008
17. Liang H., Li D., Guo W. et al. Lateral lumbar vertebral body screw predisposes to neuralgia after limb-salvage surgery for pelvic tumors: a single-center, retrospective study of 349 cases. Eur Spine J 2016;25(12):4094–102. DOI: 10.1007/s00586-016-4685-z
18. Hu X., Lu M., Wang Y. et al. Advanced pelvic girdle reconstruction with three dimensional-printed custom hemipelvic endoprostheses following pelvic tumour resection.Int Orthop 2024;48(8):2217–31. DOI: 10.1007/s00264-024-06207-3
19. Kotrych D., Angelini A., Bohatyrewicz A., Ruggieri P. 3D printing for patient-specific implants in musculoskeletal oncology. EFORT Open Rev 2023;8(5):331–9. DOI: 10.1530/EOR-23-0066
Review
For citations:
Sofronov D.I., Magomedova K.N., Efimenko O., Borzov K.A., Fedorova A.V., Kabardaev R.M., Galustov A.M., Shin A.R., Sytov A.V., Valiev A.K. The first experience of total sacral endoprothesis with an individual implant after total sacrectomy (a rare clinical case). Bone and soft tissue sarcomas, tumors of the skin. 2025;17(1):91-98. (In Russ.) https://doi.org/10.17650/2219-4614-2025-17-1-91-98