Surgical treatment of giant-cell tumors of the spine.

Three cases of relatively uncommon giant-cell tumors in the third cervical and first thoracic vertebra and the sacrum were treated surgically by radical resection and reconstruction. The tumor in the third cervical vertebra was treated by incomplete excision and anterior arthrodesis at a local hospital without pre- or postoperative radiotherapy. A recurrence was noted after four months, however, and an emergency operation was performed for severe quadriplegia. After posterior decompression, the tumor was resected by the lateral approach, and an autograft was performed. The tumor in the first thoracic vertebra was removed simultaneously by the anterior, posterior, and lateral approaches, and reconstruction was performed. The sacral tumor, which was radioresistant, was totally excised, and reconstruction was performed. Using these treatments, excellent results have been recorded after follow-up intervals of 1.5, three, and six years. Because of advancements in preoperative imaging techniques and better surgical techniques, radical resection is the recommended treatment for giant-cell tumors located in the spine.