About six months ago, I had surgery to remove a tumor in my sacral bone. This morning, I was bending over and I felt and heard a pop. I don't have any pain or further loss of motion. But I'm pretty nervous I might have broken something in there. I know I have plates and screws holding everything together. Should I call the doctor right away or wait-and-see before hitting the panic button?

Sacral tumors are fairly rare. They don't shrink or respond to radiation, so they often have to be removed surgically. The procedure is called a radical resection procedure. The tumor and surrounding tissues are removed until the pathology report shows there are clear margins. Clear margins means there is a rim of normal tissue completely surrounding the tumor. The most common tumors in the sacral region are chondrosarcomas and chordomas.

A popping sound (with or without painful symptoms or loss of motion) should be reported to your surgeon. You can call the surgeon's office and let the staff know what happened and what are your concerns. With screws, plates, and/or rods, that sound could be a sign of a pullout of a screw, a loose rod, or even a fracture.

Early investigation is advised. If it turns out to be nothing, then you have early peace of mind. If a complication has occurred, then early diagnosis and intervention can result in a better outcome than if you waited and things got worse. In some cases, revision surgery is needed.

Daniel M. Sciubba, MD, et al. Evaluation of Factors Associated with Postoperative Infection Following Sacral Tumor Resection. In Journal of Neurosurgery: Spine. December 2008. Vol. 9. No. 6. Pp. 593-599.

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