Bowel and Bladder Dysfunction and Patient-Reported Outcomes in Patients Undergoing a Sacrectomy for a Primary Bone Tumor an Observational Study From the Primary Tumor Research and Outcomes Network (PTRON)
21 affiliations
- 1Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Vancouver, BC, Canada
- 2Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, USA
- 3Department of Spinal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- 4Department of Neurosurgery, Brown University, Warren Alpert School of Medicine, Providence, RI, USA
- 5National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary
- 6Department of Orthopaedics, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- 7Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- 8Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- 9Toronto Western Hospital, University of Toronto, ON, Canada
- 10Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
- 11University Comprehensive Spine Center, University Hospital Carl Gustav Carus at the TU Dresden, Dresden, Germany
- 12Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- 13Department of Spine Surgery, IRCCS Galeazzi-Sant’Ambrogio Hospital, Milan, Italy
- 14Post Graduate Program of Orthopedics, University of Bologna, Bologna, Italy
- 15Department of Neurosurgery, University of California, San Francisco, CA, USA
- 16Department of Othopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- 17Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- 18Department of Neurosurgery, Spine Division, Duke University, Durham, NC, USA
- 19Department of Spine Surgery, University Hospital of Basel, Basel, Switzerland
- 20Department of Neurosurgery, New York University Langone Health, New York, NY, USA
- 21Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
Abstract
Study Design: Prospective cohort.
Objective: The primary objective was to describe bowel and bladder (BB) function by nerve root sacrifice following a Sacrectomy. Secondary objectives were to compare patient reported outcomes (PROs) based on BB function at 12 months, and to assess surgeon–patient reported BB function concordance.
Methods: Data from AO Spine Knowledge Forum Tumor Primary Tumor Research and Outcomes Network (PTRON) registry included patients who underwent a sacrectomy (S1–S5) for a primary bone tumor, with at least one PRO reported at baseline and 12 months. BB function was recorded at baseline and 12 months. PROs included EQ-5D, SOSGOQv2.0, SF-36, leg/back NRS, ECOG.
Results: Eighty-one patients were included. Bilateral S1–S2 sacrifice was associated with complete BB dysfunction; preservation of at least one S3 root was associated with preserved BB function in more than half of cases. Distal S4–S5 resections often preserved function, but about one-third had BB dysfunction. Agreement between surgeon–patient reported BB function was moderate (κ 0.39–0.45). At 12 months, patients with preserved BB function reported higher EQ-5D (0.70 vs 0.60, p=0.025) and SOSGOQv2.0 (83.5 vs 67.5, p=0.031), better ECOG (p= 0.028) and lower leg pain (0.5 vs 4.5, p=0.013).
Conclusion: A substantial proportion of patients experience BB dysfunction after sacrectomy, particularly with more cranial resections. This dysfunction aligned with worse PROs, greater pain, and poorer performance status. Agreement between surgeon- and patient-reported BB outcomes was moderate, emphasizing the importance of incorporating patient-reported measures into follow-up and counseling.
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BibTeX
@article{ludwig2026bowel,
title = {{Bowel and Bladder Dysfunction and Patient-Reported Outcomes in Patients Undergoing a Sacrectomy for a Primary Bone Tumor an Observational Study From the Primary Tumor Research and Outcomes Network (PTRON)}},
author = {Taryn E. Ludwig and Laurence D. Rhines and Jeremy Reynolds and Ziya L. Gokaslan and Aron Lazary and Nicolas Dea and Charles G. Fisher and Alessandro Luzzati and Alessandro Gasbarrini and Y. Raja Rampersaud and Michelle J. Clarke and Alexander C. Disch and Riccardo Cecchinato and Stefano Boriani and Praveen V. Mummaneni and Daniel G. Tobert and Ori Barzilai and C. Rory Goodwin and Cordula Netzer and Ilya Laufer and Jorrit-Jan Verlaan and Raphaële Charest-Morin},
journal = {Global Spine Journal},
year = {2026},
month = nov,
doi = {10.1177/21925682261505882},
url = {https://doi.org/10.1177/21925682261505882},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Bowel and Bladder Dysfunction and Patient-Reported Outcomes in Patients Undergoing a Sacrectomy for a Primary Bone Tumor an Observational Study From the Primary Tumor Research and Outcomes Network (PTRON)
AU - Taryn E. Ludwig
AU - Laurence D. Rhines
AU - Jeremy Reynolds
AU - Ziya L. Gokaslan
AU - Aron Lazary
AU - Nicolas Dea
AU - Charles G. Fisher
AU - Alessandro Luzzati
AU - Alessandro Gasbarrini
AU - Y. Raja Rampersaud
AU - Michelle J. Clarke
AU - Alexander C. Disch
AU - Riccardo Cecchinato
AU - Stefano Boriani
AU - Praveen V. Mummaneni
AU - Daniel G. Tobert
AU - Ori Barzilai
AU - C. Rory Goodwin
AU - Cordula Netzer
AU - Ilya Laufer
AU - Jorrit-Jan Verlaan
AU - Raphaële Charest-Morin
PY - 2026
DA - 2026/11/04
JO - Global Spine Journal
DO - 10.1177/21925682261505882
UR - https://doi.org/10.1177/21925682261505882
AB - Study Design: Prospective cohort. Objective: The primary objective was to describe bowel and bladder (BB) function by nerve root sacrifice following a Sacrectomy. Secondary objectives were to compare patient reported outcomes (PROs) based on BB function at 12 months, and to assess surgeon–patient reported BB function concordance. Methods: Data from AO Spine Knowledge Forum Tumor Primary Tumor Research and Outcomes Network (PTRON) registry included patients who underwent a sacrectomy (S1–S5) for a primary bone tumor, with at least one PRO reported at baseline and 12 months. BB function was recorded at baseline and 12 months. PROs included EQ-5D, SOSGOQv2.0, SF-36, leg/back NRS, ECOG. Results: Eighty-one patients were included. Bilateral S1–S2 sacrifice was associated with complete BB dysfunction; preservation of at least one S3 root was associated with preserved BB function in more than half of cases. Distal S4–S5 resections often preserved function, but about one-third had BB dysfunction. Agreement between surgeon–patient reported BB function was moderate (κ 0.39–0.45). At 12 months, patients with preserved BB function reported higher EQ-5D (0.70 vs 0.60, p=0.025) and SOSGOQv2.0 (83.5 vs 67.5, p=0.031), better ECOG (p= 0.028) and lower leg pain (0.5 vs 4.5, p=0.013). Conclusion: A substantial proportion of patients experience BB dysfunction after sacrectomy, particularly with more cranial resections. This dysfunction aligned with worse PROs, greater pain, and poorer performance status. Agreement between surgeon- and patient-reported BB outcomes was moderate, emphasizing the importance of incorporating patient-reported measures into follow-up and counseling.
SN - 2192-5682
SN - 2192-5690
ER -