Sacral Tumor Surgery Retaining High Sacral Nerve Root

[Objective]The retrospective study to summarize the experience about the surgical treatment of superior sacrum tumors February2002to May2011in Department of Orthopedics, QILU Hospital of Shan dong university. To observe the outcome of tumor, nerve function and limb function of patients who retaining the high sacral nerve. Provide a reference for the surgical treatment of superior sacral tumors without cutting superior high sacral nerve root.[Methods]All the28cases with superior sacral tumors treated surgically were retrospectively analyzed from Feb2002to May2011, statisticed follow information such as the surgical approaches. approach to control bleeding, operative time, intraoperative blood lossing, blood transfusion, postoperative complications, postoperative bowel and bladder and lower extremity function, tumor recurrence and survival were followed up The choice of surgical approach:3cases in front of single approach,23cases of single rear approach, before and after the combined approach of two cases.3cases blocked tumor blood vessels supplying the interventional embolization prior to surgery, operative Bank of iliac blood vessels to temporarily block the5cases,13cases of operative Bank of lower abdominal aortic balloon temporary occlusion.13cases of tumor resection in patients given fixed with the pedicle screw system of the lumbar spine and pelvis and bone grafting.[Results]The mean operative time was5.07hours (1-10hours); average intraoperative blood loss was2730ml (1000to6800ml), the average intraoperative blood transfusion was2694ml (1000to6000ml).No intraoperative death was found.5were complicated with wound rim necrosis,1were Cerebrospinal fluid leakage. All cases were followed up for an average period of4.15years(5months-9years).3cases occurred local recurrence3cases died of recurrence and lung metastases between6months to3years after surgery, No permanent neurological damage was caused by surgery, pain was relied VAS score from mean preoperative6.7points to3points or less. Nine cases of preoperative defecate and urinary dysfunction. eight cases recovery, only one patient in Bowel problems, the quality of life of patients was improved significantly[Conclusions]Most of the sacral tumor could be resected with applicating of hemorrhage control technology, Tumor could be En bloc resected together with the lower sacral nerve root,when tumor under.While tumor is located above S3some patient were difficult to accept the nerve dysfunction by sacrificing of nerve root.We could block resected the tumor retaining S1-S3nerve root as far as possible, as much as careful, if necessary, to operate under the microscope, and irrigated with distilled water in the surgical field, removed the border again after replacing equipment and glove.With introduction of new reconstruction techniques, we can get a lower relapse rate, good function of nerve and limb.