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Antero/Anterolateral Thoracic Access and Stabilization from a Posterior Approach, Costotransversectomy, and Lateral Extracavitary Approach, En Bloc Resection

  • Akash A. Shah
  • Joseph H. SchwabEmail author
Chapter

Abstract

The surgical management of tumors of the thoracic spine is challenging due to the proximity of this spinal region to critical neurovascular structures. Nonetheless, it is of the utmost importance that negative margins be obtained when resecting spinal tumors since positive margins are associated with poor outcomes. Complete resection of the tumor as a single specimen surrounded by healthy tissue – total en bloc spondylectomy (TES) – has been demonstrated to improve survival and reduce local recurrence rates.

In this chapter, we describe two cases of posterior en bloc resection for tumors of the thoracic spine. Ease of direct access to the dura above and below the spinal segments involved with tumor and direct 360° visualization of the dura represent two key advantages of the posterior approach.

Keywords

Spinal neoplasms Chondrosarcoma Ewing sarcoma Thoracic spine En bloc spondylectomy Threadwire saws 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Massachusetts General Hospital, Department of Orthopaedic SurgeryBostonUSA

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