The Hemicorporectomy in 2020: A Case Report and Recent Advances

Chronic decubitus ulcers are a common problem in spinal cord injury (SCI) patients. Late-stage ulcers often lead to chronic osteomyelitis, which carries high rates of morbidity and mortality, as well as significant healthcare costs. Refractory decubitus ulcers are most commonly seen in the pelvis and pose a clinical challenge to provider teams caring for SCI patients. With long-term disease, surgical and antibiotic therapies may fail, which places patients at risk for entering a terminal disease state. A radical treatment for this condition was described in the early 20th century and involves amputation of the lower half of the body. This procedure, the hemicorporectomy, continues to be performed today in a very small, select group of patients. Here, a case report is described of a 39-year-old female T12 paraplegic with refractory decubitus ulcers and terminal pelvic osteomyelitis that underwent hemicorporectomy as definitive treatment. The procedure was successful and the patient was safely discharged to a long-term rehabilitation facility.