Partial spondylectomy: modification for lateralized malignant spinal column tumors of the cervical or lumbosacral spine.
Total en bloc spondylectomy is a useful technique in treating primary and secondary spinal malignancies, but requires extensive instrumentation to achieve difficult fusions, and requires extensive exposure of neurovascular structures that poses additional risk of nerve root and vascular injury. More limited resections may reduce these risks, especially in the cervical or lumbosacral spine. We report a technique used in two patients with lateralized primary vertebral tumors of the cervical or lumbosacral spine where tumor removal was achieved through a partial spondylectomy. The advantages of a partial spondylectomy included: (i) avoidance of injuring contralateral neurovascular structures during exposure; and (ii) supplementation of instrumentation by additional fixation at the level of spondylectomy. Partial spondylectomy can be an alternative to total en bloc spondylectomy in properly selected patients with lateralized encapsulated malignant spinal tumors and may be performed in the cervical or lumbosacral spinal regions.
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue M779, Box 0112, San Francisco, CA 94143, USA.
John H
JH
Chi
Frank L
FL
Acosta
Henry E
HE
Aryan
Dean
D
Chou
Christopher P
CP
Ames
D002574:Cervical Vertebrae / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008488:Medical Illustration; D008875:Middle Aged; D013125:Spinal Neoplasms / Q000473:pathology* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*