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Journal article : Review

New options and techniques in reconstructing the sacrum

Abstract:
Purpose:
Sacral tumours, both benign and malignant, often necessitate surgical removal (sacrectomy) to achieve optimal outcomes. However, this procedure disrupts the pelvic ring’s stability, potentially leading to pain and limited mobility.
Methods:
This article explores innovative approaches to reconstruct the sacrum and restore function in primary and secondary sacral tumours.
Results:
Beyond traditional bone graft-based spino-pelvic fixation, the paper delves into minimally invasive alternatives like robotic-assisted surgery which may be used especially as a palliative procedure in destructive lumbosacral junction metastases. This technique offers enhanced precision for implant placement and often a reduced surgical exposure, potentially improving patient recovery. Additionally, the article discusses the application of 3D-printed custom implants, precisely matched the patient’s anatomy to provide immediate structural support. It also explores the use of vascularised long bone flaps for pelvic reconstruction to achieve both stability and ambulation after sacrectomy. Additionally, it is necessary to mention the crucial role of soft tissue reconstruction using local flaps or free flaps from other body regions.
Conclusion:
By presenting these advancements in sacral reconstruction techniques, this article empowers surgeons to select an individualised approach for their patient. This personalised approach can optimise post-operative outcomes, allowing patients to regain function and improve their quality of life.
Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1007/s00586-025-09058-7

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Clinical Neurosciences
Role:
Author
ORCID:
https://orcid.org/0000-0002-5985-9595
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Clinical Neurosciences
Oxford college:
Pembroke College
Role:
Author
ORCID:
0000-0002-4595-6482


Publisher:
Springer
Journal:
European Spine Journal More from this journal
Publication date:
2025-06-24
Acceptance date:
2025-06-11
DOI:
EISSN:
1432-0932
ISSN:
0940-6719


Language:
English
Keywords:
Subtype:
Review
Pubs id:
2132333
Local pid:
pubs:2132333
Source identifiers:
W4411598197
Deposit date:
2025-06-26
ARK identifier:

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