Soft tissues reconstruction of the lumbosacral region of the spine after tumor removal

Zhernov О.А., Kovalchuk O.I., Tsyhankov V.P.

Summary. Telangiectatic osteosarcoma (TOS) of the spine is a rare subtype of osteosarcoma and accounts for only 0.08% of all primary sarcomas. TOS is characterized by multiple, aneurysmally dilated, blood-filled cavities with highly malignant sarcomatoid cells in the peripheral rim and septa. Localization of TOS in the lumbosacral region of the spine leads to persistent and irreversible neurological changes in the lower extremities and pelvic organs. Surgical removal is the standard treatment for many oncological diseases of bones and soft tissues. Extensive resection of malignant tumors together with the affected surrounding tissues, the use of radiation therapy with the occurrence of degenerative and dystrophic changes, exposure of the bone and ligamentous structures of the spine or spinal cord, radiation dermatitis and necrosis, and impaired reparative processes lead to complex defects. Objective. To study and evaluate the effectiveness of surgical treatment of complex soft tissue defects of the lumbosacral spine after tumor removal. Materials and methods. We present a clinical case of closure of a soft tissue defect of the lumbosacral-iliac region using bilateral expanded perforated lumbosacral propeller flaps. Conclusions. The presented clinical observation confirms the difficulty of treating complex defects of the lumbosacral-iliac region after removal of telangiectatic osteosarcoma and emphasizes the importance of choosing the correct tactics for surgical treatment of the latter.

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