Extensive lumbar chordoma and unique reconstructive approach

Abstract

Chordomas are rare, malignant, low grade, primary bone tumours arising from notochord remnants. They are rarely located in the lumbar spine and consequently, the literature is lacking about the condition. There are very few case reports on the technical aspects of resection of extensive lesions such as our case. Treatment can be potentially curative only if aggressive surgical resection is utilised. We describe a case of an extensive lumbar chordoma, and demonstrate the possibility of performing a staged anterior and posterior total tumour resection with planned transgression in conjunction with an expandable cage, vascularised rib, fibula and latissimus dorsi grafts for the treatment and reconstruction of extensive spinal disease with this condition.

Osseous Reconstruction of Complex Defects of the Lumbar Spine

“…The aim of this article is to illustrate the important decision-making steps in reconstruction of complex defects of the lumbar spine. An illustrative case is presented, the oncological details of which have been reported elsewhere 5 (Fig. 1 ).…”

Vascularized Bone Grafting for Reconstruction of Oncologic Defects in the Spine: A Systematic Review and Pooled Analysis of the Literature

“…Ultimately, 21 studies met criteria for systematic review (►Table 1) and subsequent pooled analysis was executed with 12 studies. 9,11,13,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]…”

Multidisciplinary approach of lumbo‐sacral chordoma: From oncological treatment to reconstructive surgery

“…To restore stability after vertebrectomy, reconstruction is achieved through posterior instrumentation and anterior reconstruction with cages and bone graft [14,49,50,54,60,61]. Longer posterior instrumentation (more than two levels above and below the resected vertebrae) and expandable cages with graft could give better long-term results [50,62].…”