Total spondylectomy for Enneking stage III giant cell tumor of the mobile spine



We reported the surgical outcomes of total en bloc spondylectomy (TES) with intralesional T-saw transpedicular osteotomy in patients with Enneking stage III spinal giant cell tumors (GCTs).


The medical records and imaging and pathological studies of 25 consecutive patients with Enneking stage III spinal GCTs undergoing surgery at our institution who were followed for at least 2 years were retrospectively reviewed.


Eight men and 17 women (mean age: 34.2 years, range 16–51 years, at the time of surgery) were included. Six patients underwent previous tumor excision at another hospital, and one patient had a history of denosumab treatment. The GCTs were at the cervical, thoracic, and lumbar levels in three, nine, and 13 patients, respectively. TES was performed in 13 patients; 12 required intralesional pediculotomy. The remaining patients underwent total piecemeal spondylectomy with further intralesional tumor resection. During a mean follow-up of 99.2 months (range 24–216), two patients who underwent total piecemeal spondylectomy had local tumor recurrence, but no patients who underwent TES with intralesional pediculotomy had recurrence. The 2- and 10-year recurrence-free survival rates of patients treated with total piecemeal spondylectomy were 91.7% and 78.6%, respectively, while those of patients treated with TES were both 100%.


TES with intralesional pediculotomy had a good surgical outcome even in patients with Enneking stage III spinal GCT, suggesting that minimal intralesional procedures could radically cure spinal GCTs.

Graphical abstract

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Corresponding author

Correspondence to Hideki Murakami.

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Conflicts of interest

Noriaki Yokogawa, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, and Hiroyuki Tsuchiya declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.

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Informed consent was obtained from all individual participants included in the study.

IRB approval

This study was approved by the ethics committee of Kanazawa University (Japan).

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Yokogawa, N., Murakami, H., Demura, S. et al. Total spondylectomy for Enneking stage III giant cell tumor of the mobile spine. Eur Spine J 27, 3084–3091 (2018).

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  • Giant cell tumor
  • Mobile spine
  • Total en bloc spondylectomy
  • Total piecemeal spondylectomy
  • Tumor resection