Hemisacrectomy with preservation of the contralateral sacral nerve roots and sacroiliac joint for pelvic neurofibrosarcoma in a 7-year-old child: case report with 2-year follow-up

Reconstruction after hemisacrectomy with a novel 3D-printed modular hemisacrum implant in sacral giant cell tumor of the bone

Background: There are a limited but increasing number of case reports and series describing the use of 3D-printed prostheses in bone tumor surgery. Methods: We describe a new approach to performing nerve-preserving hemisacrectomy in patients with sacral giant cell tumors with reconstruction using a novel 3D-printed patient-specific modular prosthesis. The series included four female and two male patients with a mean age of 34 years (range, 28-42 years). Surgical data, imaging assessments, tumor and functional status, implant status, and complications were retrospectively analyzed in six consecutive patients. Results: In all cases, the tumor was removed by sagittal hemisacrectomy, and the prosthesis was successfully implanted. The mean follow-up time was 25 months (range, 15-32 months). All patients in this report achieved successful surgical outcomes and symptomatic relief without significant complications. Clinical and radiological follow-up showed good results in all cases. The mean MSTS score was 27.2 (range, 26-28). The average VAS was 1 (range, 0-2). No structural failures or deep infections were detected in this study at the time of follow-up. All patients had good neurological function. Two cases had superficial wound complications. Bone fusion was good with a mean fusion time of 3.5 months (range, 3-5 months). Conclusion: These cases describe the successful use of custom 3D-printed prostheses for reconstruction after sagittal nerve-sparing hemisacrectomy with excellent clinical outcomes, osseointegration, and durability.

Rare case of a recurrent juvenile ossifying fibroma of the lumbosacral spine

Juvenile ossifying fibroma (JOF) is a rare benign bone tumor that occurs most frequently in the craniofacial bones of children and young adults. There are few case reports that describe its involvement outside the craniofacial skeleton, especially within the spinal column. While JOF is classified as a benign lesion, it may be locally aggressive and demonstrate a high propensity for recurrence, even after resection. Definitive surgical management may be challenging in naive cases, but it is particularly challenging in recurrent cases and when extensive spinal reconstruction is warranted. In this report, the authors describe the diagnosis and surgical management of a 29-year-old man who presented with a large recurrent sacral trabecular-subtype JOF. A review of literature regarding JOFs, management of recurrent primary spinal tumors, and sacral reconstruction are discussed.