Primary spinal tumors are rare, challenging to diagnose, and require multidisciplinary management to provide appropriate care. The treatment selection is based on the histological grade of the tumor, its local extension, and the presence of metastasis. When surgical resection is needed, thorough planning is mandatory to achieve treatment goals, especially in the case of en bloc resection.
In many cases, an anterior lumbar retroperitoneal approach is essential to achieve appropriate oncological margins. Critical vascular, urological, and neurological structures lie in close proximity to the anterior lumbar spine. Complications associated with the anterior retroperitoneal approach should be anticipated with preventive measures and addressed in a timely fashion. Therefore, the spinal surgeon should be familiar with the retroperitoneum anatomy and its relationship to the tumor being treated. A case of an L4 chondrosarcoma illustrates the planning and execution of the anterior retroperitoneal approach to achieve a curative resection.
Primary tumor Spine Surgery Anterior approach Surgical planning Enneking classification Lumbar spine Retroperitoneal WBB Weinstein-Boriani-Biagini En bloc
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