Resection of a sacral chordoma aided by neuronavigation: A case report

Background: Chordomas are rare malignant neoplasms that are resistant to chemotherapy and conventional radiation therapy. The main factor that determines whether a localized tumor recurs is en-bloc resection with tumor-free margins. Intraoperative navigation is useful in this scenario, allowing for preoperative planning of the osteotomy. Presentation of the case: A 60-year-old patient, who had been previously operated on for prostate cancer, presented with back pain after a minor accident. He was examined, and a sacral tumor that had been classified as positive for chordoma via biopsy was found. A neuronavigation-aided en bloc resection was carried out, with both S2 nerves, both sacroiliac joints and the coccyx all preserved. Two years after the operation, the patient was asymptomatic, without tumor recurrence shown on MRI. Conclusion: The use of intraoperative navigation is a useful tool for guiding osteotomies during bone tumor en bloc resection.