Total Spondylectomy in Chondrosarcoma Arising From the Seventh Thoracic Vertebra

Abstract

1. A forty-nine-year-old man had a chondrosarcoma arising from the body of the seventh thoracic vertebra. The tumour protruded into the mediastinum and also into the spinal canal where it displaced the spinal cord. 2. At operation all the seventh thoracic vertebra and parts of the sixth and eighth were removed together with the tumour. The thoracic spine was reconstructed by inserting two iliac bone-blocks between the cut bodies of the sixth and eighth vertebrae and by wiring two strong "A. O." plates to the transverse processes of the third to the sixth and the eighth to the tenth vertebrae. 3. The patient was nursed in a plaster-of-Paris bed for three and a half months. 4. One year and three months after operation, the patient was walking and well, with no signs of recurrence or metastasis. Radiographs showed that a block-vertebra had been created from the iliac grafts and the two cut vertebrae.

En bloc spondylectomy reconstructions in a biomechanical in-vitro study

“…En bloc spondylectomy of the middle vertebra (L1) was conducted with routinely used clinical instruments. The surgical approach and technique was carried out in accordance to established surgical techniques and previous reports [14,46,51,52,58]. First, the pedicle screws were placed in the adjacent vertebras Th11, Th12, L2 and L3.…”

“…As an alternative treatment, en bloc spondylectomy of spinal malignancies has attracted growing interest. It circumvents direct exposure of the tumor tissue and enables the surgeon to reach wide resection margins of the spine [8,18,20,32,35,46,48,51,52,[58][59][60]70]. For selected patients, the en bloc resection is expected to decrease local recurrence rates and improve the patient's chances of overall survival.…”

“…For selected patients, the en bloc resection is expected to decrease local recurrence rates and improve the patient's chances of overall survival. Different authors have described complete en bloc resections of spinal tumors by an isolated dorsal approach [46,51,52], thereby limiting the intraoperative comorbidity associated with an additional anterior surgery.…”

Primary malignant bone tumors and solitary metastases of the thoracolumbar spine: results by management with total en bloc spondylectomy

“…Nevertheless, intralesional surgery predisposes the patient to local recurrences and poor prognosis. To reduce the surgery-induced tumor cell dissemination, decrease local recurrence rates and to improve survival times, different techniques [8,15,16,20,23,25,26,32] for wide resections at the spine, involving either en bloc total [32] or hemilaminectomy [18] followed by en bloc corporectomy and dorso-ventral stabilization have been developed. In early 1980, Stener and Roy-Camille were the first to describe en bloc spondylectomy via a posterior approach after complete resection of the dorsal vertebral structures, i.e., both laminae, spinous process and parts of the pedicles, resulting in an oncological adequate resection for primary bone tumor locations not extending beyond the vertebral body [23,26].…”

“…To reduce the surgery-induced tumor cell dissemination, decrease local recurrence rates and to improve survival times, different techniques [8,15,16,20,23,25,26,32] for wide resections at the spine, involving either en bloc total [32] or hemilaminectomy [18] followed by en bloc corporectomy and dorso-ventral stabilization have been developed. In early 1980, Stener and Roy-Camille were the first to describe en bloc spondylectomy via a posterior approach after complete resection of the dorsal vertebral structures, i.e., both laminae, spinous process and parts of the pedicles, resulting in an oncological adequate resection for primary bone tumor locations not extending beyond the vertebral body [23,26]. Based on these reports, several authors have begun to develop further techniques for en bloc vertebrectomy encompassing variable indications, approaches, stabilization techniques and yielding promising results in view of local control and overall prognosis [6,20,27,32,38].…”