Spine Surgery pp 505-511 | Cite as

Indications and Technique of Thoracic En Bloc Resections

  • Dominique A. RothenfluhEmail author
  • Jeremy J. Reynolds


En-bloc resections in the thoracic spine are mostly reserved for primary tumors of the spine. Rarely, en-bloc resections are considered for spinal metastases if the metastasis is solitary and can be removed en-bloc without a high likelihood of breaching the margins during the resection. Traditionally, it has been considered difficult to perform en-bloc resections in the thoracic spine due to the anatomic proximity of the major blood vessels and thus intralesional resections with curettage were preferred. This, however, resulted in a high risk of local recurrence and, in the case of a primary tumor, metastasis with poor survival. En bloc resection has the primary goals of gaining local control of the tumor by removing it as a whole and thereby reducing the rate of local recurrence and in primary tumors avoid tumor spread and improve survival [1, 4, 5].


  1. 1.
    Boriani S, Saravanja D, Yamada Y, Varga PP, Biagini R, Fisher CG. Challenges of local recurrence and cure in low grade malignant tumors of the spine. Spine (Phila Pa 1976). 2009;34(22 Suppl):S48–57.CrossRefGoogle Scholar
  2. 2.
    Boriani S, Weinstein JN, Biagini R. Primary bone tumors of the spine. Terminology and surgical staging. Spine (Phila Pa 1976). 1997;22(9):1036–44.CrossRefGoogle Scholar
  3. 3.
    Dolan RT, Butler JS, Wilson-MacDonald J, Reynolds J, Cogswell L, Critchley P, Giele H. Quality of life and surgical outcomes after soft-tissue reconstruction of complex oncologic defects of the spine and sacrum. J Bone Joint Surg Am. 2016;98(2):117–26.CrossRefGoogle Scholar
  4. 4.
    Fisher CG, Keynan O, Boyd MC, Dvorak MF. The surgical management of primary tumorsof the spine: initial results of an ongoing prospective cohort study. Spine (Phila Pa 1976). 2005;30(16):1899–908.CrossRefGoogle Scholar
  5. 5.
    Tomita K, Kawahara N, Baba H, Tsuchiya H, Fujita T, Toribatake Y. Total en bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors. Spine (Phila Pa 1976). 1997;22(3):324–33.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Oxford University Hospitals NHS Foundation Trust, Nuffield Orthopaedic CentreOxfordUK

Personalised recommendations