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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.

Original publication

DOI

10.1302/0301-620X.95B10.31734

Type

Journal article

Journal

Bone Joint J

Publication Date

10/2013

Volume

95-B

Pages

1417 - 1424

Keywords

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