Redefining the Role of Hemicorporectomy in the Modern Era and Shifting Trends Toward Non-Malignant Indications

Abstract

Hemicorporectomy, or translumbar amputation, is a radical surgical procedure in which the lower half of the body is removed. To date, 79 cases have been reported in the literature. We conducted a systematic review of the literature of articles published in peer-reviewed journals after 1990 on independent cases of hemicorporectomies. Individual case reports published before 1990 were excluded; however, a review paper from 1990 was included as a retrospective cohort and a source of comparison. Twenty-seven studies with an average follow-up period of 5.2 years reported on 40 patients who underwent hemicorporectomy from 1990 to 2021. Average age at surgery was 36.8 years, and 82.5% were male. The most common indications for the procedure were osteomyelitis of the pelvis (35%), squamous cell carcinoma (22.5%), and trauma (12.5%). Trauma had the lowest mortality rate (20%), while osteomyelitis had the highest (39%). This systematic review of 40 hemicorporectomy cases between 1990 and 2022 shows promising results, with many patients achieving significant recovery milestones, such as mobility and employment. These findings suggest that, despite its radical nature, the procedure can be a safe option for critical patients with no other feasible alternatives.