Indications and Techniques for Anterior Thoracolumbar Resections and Reconstructions

  • Benjamin D. ElderEmail author
  • Wataru Ishida
  • Jean-Paul Wolinsky


Metastatic spinal tumors are the most common spinal neoplasms and often lead to significant morbidity due to neurological dysfunction and axial pain. Indications for resection and subsequent reconstruction of thoracolumbar spine tumors include intractable pain, impending spinal instability, progressive compression of the spinal cord by bony elements, and symptomatic compression of those neural structures by radio-resistant tumors. When deciding on a surgical approach, the location of the pathology and any neural compression should be considered first. The predicted life expectancy of each patient (Tokuhashi score) should also be strongly considered when considering indications for surgery as well as determining a specific reconstruction method. Although posterior approaches are often used for spinal tumor resection, there are anterior approaches to the cervical spine, cervicothoracic junction, thoracic spine, thoracolumbar junction, and lumbar spine that will be reviewed in detail below. Each surgical approach has its advantages and disadvantages and should be carefully tailored for each patient, with the deciding focus on the location of the pathology within the spinal column.


Spinal tumors Spine metastases Transthoracic Retroperitoneal Corpectomy Cage Vertebral body replacement 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Benjamin D. Elder
    • 1
    Email author
  • Wataru Ishida
    • 2
  • Jean-Paul Wolinsky
    • 3
  1. 1.Department of NeurosurgeryThe Mayo ClinicRochesterUSA
  2. 2.Department of NeurosurgeryJohns Hopkins HospitalBaltimoreUSA
  3. 3.Department of NeurosurgeryNorthwestern UniversityChicagoUSA

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