Acta Neurochirurgica

, Volume 160, Issue 7, pp 1373–1376 | Cite as

Total en-bloc spondylectomy through a posterior approach: technique and surgical outcome in thoracic metastases

  • Maurizio Domenicucci
  • Lorenzo Nigro
  • Roberto Delfini
How I Do it - Spine - Other



In 1981, Roy-Camille et al. have firstly reported the total en-bloc spondylectomy (TES) through a posterior approach for cases of malignant spine tumors in order to reduce the local recurrence and to increase the patient’s survival. By then, this surgery has been increasingly gaining recognition. However, it requires a high level of technical ability and knowledge of spinal anatomy, physiology, and biomechanics.


Herein, we report the patient’s selection and technique to execute the TES for cases of thoracic metastasis.


This surgery is technically demanding so the patient’s selection requires a careful pre-operative evaluation. However, it can be suggested for patients affected by intracompartmental lesions with a good prognosis since the tumor’s progression is “limited” by local barriers as demonstrated by histological studies.


Spinal metastases Vertebrectomy En-bloc vertebrectomy 


Compliance with ethical standards

Informed consent

The patient has consented to the submission of the manuscript to the journal.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

701_2018_3572_MOESM1_ESM.mp4 (101.1 mb)
Video 1 a case of TES through a single posterior approach in a 39-year-old woman affected by a thoracic metastasis from breast cancer is reported. (MP4 103,547 kb)


  1. 1.
    Boriani S, Biagini R, De Iure F, Di Fiore M, Gamberini G, Zanoni A (1994) Vertebrectomia lombare per neoplasia ossea: tecnica chirurgica. Chir Organi Mov 79:163–173PubMedGoogle Scholar
  2. 2.
    Enneking WF, Spanier SS, Goodmann MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop 153:106–120Google Scholar
  3. 3.
    Harrington KD (1986) Metastatic disease of the spine. J Bone Joint Surg Am 68:1110–1115CrossRefPubMedGoogle Scholar
  4. 4.
    Roy-Camille R, Saillant G, Bisserie M, Judet TH, Hautefort E, Mamoudy P (1981) Resection vertebrale totale dans la chirurgie tumorale au niveau du rachis dorsal par voie posterieure pure. Rev Chir Orthop 67:421–430PubMedGoogle Scholar
  5. 5.
    Sciubba DM, De la Garza RR, Goodwin CR, Xu R, Bydon A, Witham TF, Gokaslan ZL, Wolinsky JP (2016) Total en bloc spondylectomy for locally aggressive and primary malignant tumors of the lumbar spine. Eur Spine J 25(12):4080–4087CrossRefPubMedGoogle Scholar
  6. 6.
    Stener B (1989) Complete removal of vertebrae for extirpation of tumors. Clin Orthop 245:72–82Google Scholar
  7. 7.
    Sundaresan N, Rosen G, Huvos AG, Krol G (1988) Combined treatment of osteosarcoma of the spine. Neurosurgery 23:714–719CrossRefPubMedGoogle Scholar
  8. 8.
    Tokuhashi Y, Matsuzaki H, Toriyama S, Kawano H, Ohsaka S (1990) Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine 15:1110–1113CrossRefPubMedGoogle Scholar
  9. 9.
    Tomita K, Kawahara N, Baba H, Tsuchiya H, Fujita T, Toribatake Y (1997) Total en bloc spondylectomy: a new surgical technique for primary malignant vertebral tumors. Spine 22:324–333CrossRefPubMedGoogle Scholar
  10. 10.
    Yokogawa N, Murakami H, Demura S, Kato S, Yoshioka K, Tsuchiya H (2018) Incidental durotomy during total en bloc spondylectomy. Spine J 18(3):381–386CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Maurizio Domenicucci
    • 1
  • Lorenzo Nigro
    • 1
  • Roberto Delfini
    • 1
  1. 1.Department of Neurology and PsychiatryUniversity of RomeRomeItaly

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