Abstract
BACKGROUND: 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. The technology integrating 3D reconstruction models in the field of spine surgery is rapidly evolving, and these challenging cases present a unique opportunity to leverage this technology's capability for enhanced patient outcomes. OBSERVATIONS: The authors present two sacral tumor cases diagnosed with synovial cell sarcoma and giant cell osteosarcoma, respectively. Both patients underwent a three-staged en bloc tumor resection assisted by 3D reconstruction models. Postoperative imaging showed a complete tumor resection, and the patients symptomatically improved, with no signs of recurrence on follow-up. LESSONS: Surgical planning and execution have clearly advanced significantly with the introduction of 3D modeling into spine surgery. Based on the authors' experience, this technology can be used to improve outcomes for complicated spinal tumors with successful results. Although these results are encouraging, extensive studies with larger patient cohorts must be carried out to fully appreciate the technology's advantages across a range of patient demographics and tumor types. https://thejns.org/doi/10.3171/CASE2522.