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We hypothesised that the use of computer navigation-assisted surgery for pelvic and sacral tumours would reduce the risk of an intralesional margin. We reviewed 31 patients (18 men and 13 women) with a mean age of 52.9 years (13.5 to 77.2) in whom computer navigation-assisted surgery had been carried out for a bone tumour of the pelvis or sacrum. There were 23 primary malignant bone tumours, four metastatic tumours and four locally advanced primary tumours of the rectum. The registration error when using computer navigation was < 1 mm in each case. There were no complications related to the navigation, which allowed the preservation of sacral nerve roots (n = 13), resection of otherwise inoperable disease (n = 4) and the avoidance of hindquarter amputation (n = 3). The intralesional resection rate for primary tumours of the pelvis and sacrum was 8.7% (n = 2): clear bone resection margins were achieved in all cases. At a mean follow-up of 13.1 months (3 to 34) three patients (13%) had developed a local recurrence. The mean time alive from diagnosis was 16.8 months (4 to 48). Computer navigation-assisted surgery is safe and has reduced our intralesional resection rate for primary tumours of the pelvis and sacrum. We recommend this technique as being worthy of further consideration for this group of patients.

Type

Journal article

Journal

The bone & joint journal

Publication Date

10/2013

Volume

95-B

Pages

1417 - 1424

Addresses

The Royal Orthopaedic Hospital, Birmingham B31 2AP, UK.

Keywords

Pelvic Bones, Sacrum, Humans, Chondrosarcoma, Bone Neoplasms, Neoplasm Recurrence, Local, Neoplasm, Residual, Tomography, X-Ray Computed, Magnetic Resonance Imaging, Treatment Outcome, Intraoperative Care, Preoperative Care, Surgery, Computer-Assisted, Follow-Up Studies, Prospective Studies, Adolescent, Adult, Aged, Middle Aged, Female, Male, Young Adult