Rebuilding the link between spine and pelvis after sacrectomy | CION Cancer Clinics

It is the part of the operation that reconnects your spine to your pelvis after a high or total sacrectomy has removed the bone that joined them. Surgeons usually do it with metal rods and screws, plus bone graft that grows into a solid bridge over time.

Why it is needed

The sacrum is the keystone that carries the weight of your upper body down into the hips and legs. When it is removed high enough, the spine has nothing to rest on. Without reconstruction, you could not sit or stand safely, and the spine would slowly sink into the pelvis.

When it is not needed

After a low sacrectomy, the joints between the sacrum and the hip bones are left in place, so the spine stays supported. Most people with a low cut do not need rods. Your surgeon decides from the MRI and CT how much bone must go, and whether reconstruction is part of the plan.

Who is in theatre for it

Reconstruction is usually done in the same operation as the tumour removal, straight after the bone comes out. A surgical oncologist removes the tumour. A spine surgeon places the rods and screws. A plastic surgeon often closes the large wound. Ask your team who will be doing each part, and whether they have worked together on this kind of operation before.

What this page cannot tell you

It cannot tell you which method your surgeon will use. That depends on how much bone is removed, the quality of your bone, whether you have had radiotherapy, and what your centre has experience with.

Reconstruction lets you sit, stand and walk again, but it adds its own risks. Your surgeon should explain each one for your operation, with the rates their team sees.

Wound problems and infection

The wound is large and sits close to the back passage. Breakdown of the wound is the most common problem. If infection reaches the metal, it may need antibiotics for a long time, a washout in theatre, and sometimes removal of some hardware.

Loosening, breaking and slow fusion

The rods carry the whole weight of the upper body until the bone graft fuses. If fusion is slow, a rod can break or a screw can loosen, often months later. Radiotherapy, smoking and poor nutrition all slow fusion. Some of these problems need another operation.

Who it may not suit

For someone who is very frail, or whose cancer has spread widely, a large reconstruction may add more strain than benefit. The team may then suggest radiotherapy or a smaller operation. That decision belongs to you and your treating team together.