Introduction: The surgical methods used to resect sacral tumors are extensive and require maneuvering through complex anatomical systems such as the pelvic organs and sacral nerve roots. These procedures may result in complications and adverse patient outcomes. Integrating 3D-reconstruction models in spine surgery is rapidly evolving, and these challenging cases present a unique opportunity to leverage this technology's capability for enhanced patient outcomes.
Methods: To present technical nuances on our initial experience utilizing patient-specific 3D models for sacral tumor resection.
Results: We present two sacral tumor cases diagnosed with synovial cell sarcoma and giant cell osteosarcoma, respectively. Both patients underwent a 3-staged en-bloc tumor resection assisted by 3D reconstruction models. Post-operative imaging showed a complete tumor resection, and the patients symptomatically improved, with no signs of recurrence on follow-up. 3D reconstructions of the patient’s sacral pre- and post-operative anatomies were achieved using Surgical Theater SyncAR Spine software. Sacral bony and soft tissue anatomy was visualized by fusing pre-operative thin-slice CT and MRIs and segmentation of the dural sac, nerve roots, sarcomas, and ossified tumor (if relevant). The SyncAR Spine system is integrated with the intraoperative CT scan and neuronavigation system, enabling the surgeon to navigate the patient’s soft tissue anatomy to aid in osteotomies and tumor resection via a heads-up display.
Conclusion : Surgical planning and execution have advanced significantly with the introduction of 3D modeling into spine surgery. Based on our experience, this technology can be used to improve the standard of care for complicated spinal tumors with successful results. Although our results are encouraging, extensive studies with larger patient cohorts must be carried out to fully appreciate the technology's advantages across various patient demographics and tumor types.