Midsacral Amputation for En Bloc Resection of Chordoma

BACKGROUND: En bloc resection, with adequate surgical margins, of primary malignant bone tumors of the sacrum is associated with long term disease control and potential cure. Resection of sacral tumors is difficult due to the proximity of neurovascular and visceral structures, and complete, or even partial, sacrectomy often results in functional loss for the patient. OBJECTIVE: We describe the technique for en bloc resection of a sacral chordoma through a mid-sacral amputation. RESULTS: We demonstrate successful removal of a large sacral tumor with wide surgical margins while preserving neurologic function. CONCLUSION: This technique for midsacral amputation to remove a sacral tumor en bloc minimizes local recurrence and maximizes neurovascular function.