Tang X, et al. - In this retrospective study, researchers assessed the rate and type of mechanical fixation failure following total sacrectomy, as well as identified the associated risk factors by analyzing data of 63 subjects who had spinopelvic reconstruction following total sacrectomy. Univariate analysis demonstrated that non-adoption of four-rod technique (FRT) of spinopelvic fixation (SPF) and anterior spinal column fixation (ASCF), the adoption of Type II sacroiliac resection, and female sex were related to SPF mechanical failure after total sacrectomy. Multivariate analysis showed similar outcomes, with the exception of the adoption of Type II sacroilliac resection. Particularly in female patients, FRT connection of SPF and ASCF should be adopted in reconstruction following total sacrectomy.