BACKGROUND: En bloc resection of spinal and sacral chordomas may convey a survival benefit. However, these procedures often are complex and require the surgeon to plan a procedure that results in negative tumor margins, protects vital neurovascular structures, and concludes with a viable biomechanical reconstruction.
OBJECTIVE: We present a case of a 3-level en bloc lumbar spondylectomy and reconstruction.
METHODS: A case of a 45-year-old woman with biopsy-proven exophytic L4 chordoma is presented. The patient underwent successful L3-L5 en bloc spondylectomy and reconstruction over 3 stages.
RESULTS: The patient did well following the procedure, and was neurologically intact at 6-week follow-up.
CONCLUSION: Three-level en bloc spondylectomy with lumbopelvic reconstruction is a challenging yet feasible procedure.
*Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota; ‡Department of Neurosurgery, §Department of Pathology, ¶Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland
Received, April 15, 2010.
Accepted, October 21, 2010.
Correspondence: Jean-Paul Wolinsky, MD, Department of Neurosurgery, Johns Hopkins University, 600 Wolfe Street, Meyer 7-109, Baltimore, MD 21287. E-mail: email@example.com