Successful treatment for rhabdomyosarcoma by total spondylectomy in a child.

A 7-year-old girl with a retroperitoneal rhabdomyosarcoma having invaded the L3 vertebra was treated by combination therapy consisting of chemotherapy, surgical resection and intraoperative radiation. Surgically, total spondylectomy was performed through a combined anterior and posterior procedures, and the spine was reconstructed with fibula bone grafts using a pedicle screw system made of titanium alloy. Transverse junction plates were not used at operation because of their bulkiness for the patient. Five days postoperatively, the rods dislodged from the screws and the grafted bones leaned. A Chance fracture-like transverse fracture of the L4 vertebra occurred during the revisional operation. Transverse plates and sublaminar wires were used to reduce the fracture and achieved stability. Six years postoperatively, the spine was completely fused and no local recurrence or metastasis is detected.