Total en bloc spondylectomy for primary malignant vertebral tumors.

It is the purpose of this study to report our new surgical technique and the outcome of total en bloc spondylectomy (TES) to resect the primary spinal tumor as a whole in order to ensure oncological curability. TES consisting of en bloc laminectomy and en bloc corporectomy was performed on 7 patients with primary vertebral tumors between 1989 and 1993. There were 2 osteosarcomas, 1 malignant fibrous histiocytoma, 1 chondrosarcoma, 1 undifferentiated sarcoma, 1 solitary plasmocytoma, and 1 giant cell tumor. All of the patients had partial or complete pain relief after TES. None of the patients worsened neurologically after surgery and there was no local recurrence following TES, except for 1 patient who died 3 months postsurgery as a result of a tumor developing in the mediastinum. The advantage of TES is en bloc resection of the affected vertebrae by marginal or wide margin, not piecemeal pattern. This new surgical technique offers the most radical therapy of primary malignant tumors.