Introduction We present here a surgical technique using a navigation system and an oscillating saw for the resection of a pelvic bone tumor combined with an allograft reconstruction.
Step 1: Preoperative PlanningThe surgeon and radiologist together delineate the tumor on each magnetic resonance imaging (MRI) slice; then the surgeon defines target planes for tumor resection and transfers them to the allograft.
Step 2: Patient Positioning and Surgical ExposureWith the patient in the lateral decubitus position, combine ilioinguinal with iliocrural and obturator surgical approaches to expose the ilium.
Step 3: Navigated Tumor ResectionPerform the osteotomies using the navigation system to guide the saw blade, following predefined target planes; perform a biopsy.
Step 4: Navigated Allograft CuttingPerform the osteotomies using the navigating saw, following the same target planes as used for the tumor resection.
Step 5: Pelvic ReconstructionFix the graft and cement a femoral stem in place; then reinsert all detached tendons and elevated muscles.
Results & Preop./Postop. Images Editor's note: This technique is based on preliminary work that has not been presented in a peer-reviewed case series publication.
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We present here a surgical technique using a navigation system and an oscillating saw for the resection of a pelvic bone tumor combined with an allograft reconstruction.
Surgical resection of a malignant bone tumor within the pelvis is a difficult procedure because of the complex three-dimensional architecture of the pelvic bone and the proximity of several soft-tissue structures such as vessels, the bladder, the rectum, and the sciatic nerve1. Good bone-cutting accuracy is mandatory to achieve an adequate safe margin of tumor resection and minimize the risk of local tumor recurrence2-4. Local recurrence rates ranging from 28% to 35% have been reported after …
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