Total spondylectomy and circular reconstruction for L5 vertebral body chordoma using a telescopic lordotic cage

Wenger, Markus; Teuscher, Jürg; Markwalder, Regula; Markwalder, Thomas-Marc

doi:10.1080/17453670610013060

Cited by 6 publications

(1 citation statement)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some surgeons have removed the L5 vertebral body via the interval space between the bifurcation of the common iliac vessels 5) . However, the cranial retraction of the common iliac vessels may cause vascular injury during L5 vertebral body extraction 7) , particularly to the fragile common iliac veins because the bifurcation of the common iliac veins is located anterior to the L5 (Fig. 5) but not the L4 vertebral body, as illustrated in a report 5) .…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique of Vertebral Body Removal and Anterior Reconstruction in L5 Spondylectomy

Sangsin

Murakami

Shimizu

et al. 2018

Spine Surg Relat Res

View full text Add to dashboard Cite

Introduction: L5 spondylectomy for the treatment of spinal tumor is a technically demanding surgery because of the complex anatomy of major vessels, the obscurity of the posterior exposure from the iliac wings, and the increased comparative size of the L5 vertebral body. In this study, we present a surgical technique of L5 spondylectomy, vertebral body removal, and anterior reconstruction for a case with solitary spinal metastatic renal cell carcinoma (RCC). Technical Note: A 54-year-old man underwent right total nephrectomy for RCC one year ago. At the one-year postoperative follow-up, CT scan and MRI revealed a solitary L5 spinal metastasis. A two-stage posteroanterior approach was performed. To facilitate vertebral body removal, transverse processes were separated from the vertebral body by using the posterior approach. On the basis of the anterior approach, the vertebral body was removed via the interval space between the left common iliac vessels. Reconstruction was performed by using a liquid-nitrogen-frozen, tumor-bearing bone mixed with an autogenous bone graft in an expandable titanium cage. Results: No intraoperative complications were observed. Postoperatively, the patient exhibited muscle weakness in the tibialis anterior and extensor hallucis longus bilaterally but improved with time. Seven months after the operation, the patient was able to walk independently. At the recent 2.5-year follow-up, the local recurrence of lesions was nonexistent. The bone graft had fused with the adjacent vertebrae. Conclusion: This report described a novel technique for L5 spondylectomy that can facilitate safe L5 vertebral body removal and demonstrated the effectiveness of liquid-nitrogen-frozen, tumor-bearing bone mixed with autogenous bone graft in anterior reconstruction both in terms of oncologic safety and biological healing.

show abstract

Section: Discussionmentioning

confidence: 99%