Partial sacrectomy with patient-specific osteotomy guides

BACKGROUND: Chordomas are rare, locally aggressive, malignant tumors. Surgical resection with sufficient margins defines the outcome. However, the necessity for wide margins often leads to sacrifice of important neurological structures. 3D-printed osteotomy guides are a promising solution for precise execution of surgical resection. We present probably the first sacrococcygeal chordoma resection with 3D-printed guides. METHODS: The case of a 49-year-old woman with a sacrococcygeal chordoma, resected with help of 3-D pre-operative planning and patient-specific 3D-printed osteotomy guides, is reported in detail. RESULTS: A sufficient tumor excision could be performed successfully while sparing nerve root S4. The planed margin has been exactly maintained, as confirmed by histology. The patient demonstrated an excellent clinical outcome with no evidence of local recurrence. CONCLUSIONS: 3-D pre-operative planning and patient-specific osteotomy guides can be used for planning and performing en-bloc surgical resection of sacral chordomas.