Sacrectomy

Sacrectomy is primarily recommend as treatment for the following conditions:

1. Sacral Tumors: The most common reason for performing a sacrectomy is to remove malignant tumors such as chordomas, sarcomas, and other types of cancer that originate in or spread to the sacrum.
2. Infections: Chronic infections that do not respond to conservative treatments may necessitate the removal of part or all of the sacrum.
3. Trauma: Traumatic injuries to the sacrum or coccyx that result in ligament or bone damage may require surgical intervention.

The type of sacrectomy performed depends on the extent and location of the disease or damage:

1. Partial Sacrectomy: Only a portion of the sacrum is removed. This is typically done when the disease is localized and does not involve the entire sacrum.
2. Total Sacrectomy: The entire sacrum is removed. This is a more extensive procedure, usually reserved for cases where the disease is widespread throughout the sacrum.

A sacrectomy requires significant preoperative planning including extensive imaging studies such as MRI and CT scans to assess the extent of the disease and plan the surgery.

The procedure can be performed through an anterior (from the front), posterior (from the back), or combined approach. Dr. Colman will remove the affected parts of the sacrum while preserving as much healthy tissue as possible. Following the removal of the sacrum, the spine and pelvis may require reconstruction and stabilization using metal rods, screws, and bone grafts to maintain structural integrity and support.

Recovery from a sacrectomy can be extensive and challenging:

1. Patients typically stay in the hospital for one to two weeks or longer, depending on the complexity of the surgery and their overall health.
2. Pain is managed with medications.
3. Bowel and bladder function may be affected depending on the extent of sacrum removed. A training program to help manage bowel and bladder dysfunction is critical in the early postoperative period.
4. Physical therapy and rehabilitation are crucial to help patients regain strength and mobility. This may include learning new ways to move and perform daily activities.
5. Regular follow-up visits with the surgical team are necessary to monitor healing, manage any complications, and assess the need for additional treatments.

The success of a sacrectomy largely depends on the underlying condition being treated and the extent of the surgery. Patients with localized tumors that are completely removed typically have better outcomes.

In summary, a sacrectomy is a complex and demanding surgical procedure aimed at treating serious conditions affecting the sacrum. While it carries significant risks, it can provide relief from pain, remove malignant tumors, and improve the quality of life for patients with otherwise intractable sacral diseases.