Total En Bloc Spondylectomy for Solitary Spinal Metastasis without Special Instruments: A Modified Technique

Main Article Content

Pongsthorn Chanplakorn
Chairet Nithisathien
Kittidet Naovaratpanommas

Abstract

Primary malignant vertebral tumor and solitary spinal metastasis are indications for the total en bloc spondylectomy (TES). The major advantage of this procedure is to minimize the risk of tumor cell contamination, lower local recurrent rate, improve survival time and quality of life for these particular patients. However, with respect to the surgical technique, TES requires the special instruments that are not available in Thailand. Thus, we need to adapt the surgical techniques for the success in this procedure. We succeed the TES procedure without using the special instruments. Therefore, the objectives of this report is to illustrate our modifications of the original surgical technique to achieve the successful TES procedure using general standard surgical equipments. The steps of our approach will be discussed in the detail. However, careful selection of patients, considering of the underlying tumor type and its extension are essential for the successful outcome.

Article Details

How to Cite
Chanplakorn, P., Nithisathien, C., & Naovaratpanommas, K. (2011). Total En Bloc Spondylectomy for Solitary Spinal Metastasis without Special Instruments: A Modified Technique. Ramathibodi Medical Journal, 34(3), 141–149. Retrieved from https://he02.tci-thaijo.org/index.php/ramajournal/article/view/137790
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Original Articles

References

Fujita T, Ueda Y, Kawahara N, Baba H, Tomita K. Local spread of metastatic vertebral tumors. A histologic study. Spine (Phila Pa 1976). 1997;22(16):1905-12. doi:10.1097/00007632-199708150-00020.

Stener B. Total spondylectomy in chondrosarcoma arising from the seventh thoracic vertebra. J Bone Joint Surg Br. 1971;53(2):288-95.

Stener B, Johnsen OE. Complete removal of three vertebrae for giant-cell tumour. J Bone Joint Surg Br. 1971;53(2):278-87.

Stener B. Complete removal of vertebrae for extirpation of tumors. A 20-year experience. Clin Orthop Relat Res. 1989;(245):72-82.

Sundaresan N, Rosen G, Huvos AG, Krol G. Combined treatment of osteosarcoma of the spine. Neurosurgery. 1988;23(6):714-9. doi:10.1227/00006123-198812000-00005.

Kawahara N, Tomita K, Murakami H, Demura S. Total en bloc spondylectomy for spinal tumors: surgical techniques and related basic background. Orthop Clin North Am. 2009;40(1):47-63, vi. doi:10.1016/j.ocl.2008.09.004.

Tomita K, Kawahara N, Murakami H, Demura S. Total en bloc spondylectomy for spinal tumors: improvement of the technique and its associated basic background. J Orthop Sci. 2006;11(1):3-12. doi:10.1007/s00776-005-0964-y.

Melcher I, Disch AC, Khodadadyan-Klostermann C, Tohtz S, Smolny M, Stöckle U, et al. Primary malignant bone tumors and solitary metastases of the thoracolumbar spine: results by management with total en bloc spondylectomy. Eur Spine J. 2007;16(8):1193-202. doi:10.1007/s00586-006-0295-5.

Kawahara N, Tomita K, Fujita T, Maruo S, Otsuka S, Kinoshita G. Osteosarcoma of the thoracolumbar spine: total en bloc spondylectomy. A case report. J Bone Joint Surg Am. 1997;79(3):453-8. doi:10.2106/00004623-199703000-00022.

Nishida K, Doita M, Kawahara N, Tomita K, Kurosaka M. Total en bloc spondylectomy in the treatment of aggressive osteoblastoma of the thoracic spine. Orthopedics. 2008;31(4):403.

Tomita K, Kawahara N, Baba H, Tsuchiya H, Nagata S, Toribatake Y. Total en bloc spondylectomy for solitary spinal metastases. Int Orthop. 1994;18(5):291-8. doi:10.1007/bf00180229.

Murakami H, Kawahara N, Demura S, Kato S, Yoshioka K, Tomita K. Neurological function after total en bloc spondylectomy for thoracic spinal tumors. J Neurosurg Spine. 2010;12(3):253-6. doi:10.3171/2009.9.SPINE09506.

Tomita K, Kawahara N, Kobayashi T, Yoshida A, Murakami H, Akamaru T. Surgical strategy for spinal metastases. Spine (Phila Pa 1976). 2001;26(3):298-306. doi:10.1097/00007632-200102010-00016.

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