Musculoskeletal Oncology Center, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China.
J Neurosurg Spine. 2010 Nov;13(5):651-8. doi: 10.3171/2010.5.SPINE09443.
The authors propose a new surgical classification method for sacral tumors that improves the guidance for specific surgical decisions and approaches.
The authors retrospectively studied the clinical courses of 92 patients with sacral tumors treated at the Changhai Hospital; all patients underwent tumor resection between January 2000 and August 2005. The clinical characteristics, imaging features, and pathological classifications were carefully assessed in each case. The tumors were classified according to the imaging features and intraoperative findings. The surgical approach and the resection area were determined according to the tumor classification.
The proposed surgical classification system divided the sacral tumors into 2 major types according to the lesion's anatomical position in the sagittal plane. The tumors were further divided into 4 subtypes according to the length of the tumor's anterior protrusion into the pelvic cavity. Finally, each tumor subtype was classified into 16 areas according to the anatomical position in the cross-sectional plane. This classification method was used to categorize the sacral tumors, all of which were totally resected under the naked eye. Postoperatively symptoms were improved to varying degrees.
The appropriate classification of sacral tumors and the selection of a corresponding surgical approach can improve the rate of total resection and the surgical safety, as well as decrease the recurrence rate.
作者提出一种新的骶骨肿瘤外科分类方法，旨在为特定的手术决策和入路提供更好的指导。
作者回顾性研究了 92 例在长海医院接受治疗的骶骨肿瘤患者的临床过程；所有患者均于 2000 年 1 月至 2005 年 8 月期间接受肿瘤切除术。在每个病例中，仔细评估了患者的临床特征、影像学特征和病理分类。根据影像学特征和术中所见对肿瘤进行分类。根据肿瘤分类确定手术入路和切除范围。
提出的外科分类系统根据矢状面病变的解剖位置将骶骨肿瘤分为 2 大类型。根据肿瘤向盆腔内前突的长度，将肿瘤进一步分为 4 个亚型。最后，根据横断面的解剖位置，将每个肿瘤亚型分为 16 个区域。该分类方法用于对骶骨肿瘤进行分类，所有肿瘤均在肉眼下完全切除。术后症状均得到不同程度的改善。
对骶骨肿瘤进行适当的分类并选择相应的手术入路，可以提高全切除率和手术安全性，降低复发率。
