Surgical Planning in Cervical Spine Oncologic Patients

  • S. BorianiEmail author
  • R. Ghermandi
  • M. Girolami
  • A. Gasbarrini


Primary bone tumors of the spine are very rare [1]; they comprise only 10 % or less of all bone tumors. In the United States, about 7,500 new cases are estimated per year. The overall world occurrence can be expected 2.5–8.5 cases per million inhabitants per year. Compared to primary spinal tumors, metastatic tumors are much more common in the spine: the spine is the most common skeletal region for secondary tumors. Basic knowledge about diagnosis and treatment strategy must be known for early recognition of a spine tumor. Further, diagnostic elements to differentiate primary from metastatic tumor are required.


Cervical Spine Vertebral Body Vertebral Artery Epidural Space Bloc Resection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The author acknowledges the outstanding contribution of Carlo Piovani for data collection and original drawings.


  1. 1.
    Chi JH, Ali B, Patrick H, Tim W, Jean-Paul W, Gokaslan ZL (2008) Epidemiology and demographics for primary vertebral tumors. Neurosurg Clin N Am 19:1–4CrossRefPubMedGoogle Scholar
  2. 2.
    Enneking WF, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 153:106–120Google Scholar
  3. 3.
    Boriani S, Capanna R, Donati D, Levine A, Picci P, Savini R (1992) Osteoblastoma of the spine. Clin Orthop 278:37–45Google Scholar
  4. 4.
    Boriani S, Bandiera S, Biagini R, Bacchini P, Boriani L, Cappuccio M et al (2006) Chordoma of the mobile spine: fifty years of experience. Spine 31(4):493–503CrossRefPubMedGoogle Scholar
  5. 5.
    Hart RA, Boriani S, Biagini R, Currier B, Weinstein JN (1997) A system for surgical staging and management of spine tumors. A clinical outcome study of giant cell tumors of the spine. Spine 22:1773–1782CrossRefPubMedGoogle Scholar
  6. 6.
    Boriani S, De Iure F, Bandiera S, Campanacci L, Biagini R, Di Fiore M, Bandello L, Picci P, Bacchini P (2000) Chondrosarcoma of the mobile spine. Report on 22 cases. Spine 25:804–812CrossRefPubMedGoogle Scholar
  7. 7.
    Simon MA (1998) Surgical margins. In: Simon MA, Springfield D (eds) Surgery for bone and soft tissue tumors. Lippincott-Raven, Philadelphia, pp 77–92Google Scholar
  8. 8.
    Stener B, Johnsen OE (1971) Complete removal of three vertebrae for giant-cell tumour. J Bone Joint Surg Br 53(2):278–287PubMedGoogle Scholar
  9. 9.
    Roy-Camille R, Montpierre H, Mazel C, Saillant G (1990) Technique de vertebrectomie totale lombaire. In: Roy-Camille R (ed) Rachis Dorsal et Lombaire Septieme Journees d'Orthopedie de la Pitié. Masson, Paris, pp 49–52Google Scholar
  10. 10.
    Tomita K, Kawahara N, Baba H, Tsuchiya H, Nagata S, Toribatake Y (1994) Total en bloc spondylectomy for solitary spinal metastases. Int Orthop 18(5):291–298CrossRefPubMedGoogle Scholar
  11. 11.
    Boriani S, Weinstein JN, Biagini R (1997) Spine update. A surgical staging system for therapeutic planning of primary bone tumors of the spine. A contribution to a common terminology. Spine 22:1036–1044CrossRefPubMedGoogle Scholar
  12. 12.
    Chan P, Boriani S, Fourney DR, Biagini R, Dekutoski MB, Fehlings MG et al (2009) An assessment of the reliability of the Enneking and Weinstein-Boriani-Biagini classifications for staging of primary spinal tumors by the Spine Oncology Study Group. Spine 34:384–391CrossRefPubMedGoogle Scholar
  13. 13.
    Magerl F, Coscia MF (1988) Total posterior vertebrectomy of the thoracic or lumbar spine. Clin Orthop Relat Res 232:62–69Google Scholar
  14. 14.
    Fidler MW (1994) Radical resection of vertebral body tumours. A surgical technique used in ten cases. J Bone Joint Surg Br 76(5):765–772PubMedGoogle Scholar
  15. 15.
    Mazel C, Grunenwald D, Laudrin P, Marmorat JL (2003) Radical excision in the management of thoracic and cervicothoracic tumors involving the spine: results in a series of 36 cases. Spine 28(8):782–792PubMedGoogle Scholar
  16. 16.
    Boriani S (2000) Subtotal and total vertebrectomy for tumours. Surgical techniques in orthopedics and traumatology. Elsevier, Paris, Editions Scientifiques et MedicalesGoogle Scholar
  17. 17.
    Fujita T, Kawahara N, Matsumoto T, Tomita K (1999) Chordoma in the cervical spine managed with en bloc excision. Spine 24(17):1848–1851CrossRefPubMedGoogle Scholar
  18. 18.
    Rhines LD, Fourney DR, Siadati A, Suk I, Gokaslan ZL (2005) En bloc resection of multilevel cervical chordoma with C-2 involvement. Case report and description of operative technique. J Neurosurg Spine 2(2):199–205CrossRefPubMedGoogle Scholar
  19. 19.
    Currier BL, Papagelopoulos PJ, Krauss WE, Unni KK, Yaszemski MJ (2007) Total en bloc spondylectomy of C5 vertebra for chordoma. Spine 32(9):E294–E299CrossRefPubMedGoogle Scholar
  20. 20.
    Leitner Y, Shabat S, Boriani L, Boriani S (2007) En bloc resection of a C4 chordoma: surgical technique. Eur Spine J 16(12):2238–2242CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Talac R, Yaszemski MJ, Currier BL et al (2002) Relationship between surgical margins and local recurrence in sarcomas of the spine. Clin Orthop 397:127–132CrossRefGoogle Scholar
  22. 22.
    Bergh P, Gunterberg B, Meis-Kindblom JM, Kindblom LG (2001) Prognostic factors and outcome of pelvic, sacral, and spinal chondrosarcomas: a center-based study of 69 cases. Cancer 91(7):1201–1212CrossRefPubMedGoogle Scholar
  23. 23.
    Boriani S, Saravanja D, Yamada Y, Varga Peter P, Biagini R, Fisher Charles G (2009) Challenges of local recurrence and cure in Low grade malignant tumors of the spine. Spine 34(22S):S48–S57CrossRefPubMedGoogle Scholar
  24. 24.
    Boriani S, Amendola L, Corghi A, Cappuccio M, Bandiera S, Ferrari S, Picci R, Di Fiore M, Gasbarrini A (2011) Ewing’s sarcoma of the mobile spine. Eur Rev Med Pharmacol Sci 15:831–839PubMedGoogle Scholar
  25. 25.
    Sciubba DM, Okuno SH, Dekutoski MB, Gokaslan ZL (2009) Ewing and osteogenic sarcoma: evidence for multidisciplinary management. Spine (Phila Pa 1976) 34(22 Suppl):S58–S68CrossRefGoogle Scholar
  26. 26.
    Faciszewski T, Winter RB, Lonstein JE, Denis F, Johnson L (1995) The surgical and medical perioperative complications of anterior spinal fusion surgery in the thoracic, lumbar spine in adults. A review of 1223 procedures. Spine 20:1592–1599CrossRefPubMedGoogle Scholar
  27. 27.
    McDonnell MF, Glassman SD, Dimar JR, Puno HMR, Johnson JB (1996) Perioperative complications of anterior procedures of the spine. J Bone Joint Surg Am 78:839–847CrossRefPubMedGoogle Scholar
  28. 28.
    Smith JS, Saulle D, Chen CJ, Lenke LG, Polly DW Jr, Kasliwal MK, Broadstone PA, Glassman SD, Vaccaro AR, Ames CP, Shaffrey CI (2012) Rates and causes of mortality associated with spine surgery based on 108,419 procedures: a review of the Scoliosis Research Society Morbidity and Mortality Database. Spine (Phila Pa 1976) 37(23):1975–1982CrossRefGoogle Scholar
  29. 29.
    Di Fiore M, Lari S, Boriani S, Formaro G, Perin S, Malferrari A, Zanoni A (1998) Major vertebral surgery: intra- and postoperative anaesthesia-related problems. Chir Org Mov 83:65–72Google Scholar
  30. 30.
    Boriani S, Bandiera S, Donthineni R, Amendola L, Cappuccio M, De Iure F, Gasbarrini A (2010) Morbidity of en bloc resections in the spine. Eur Spine J 19:231–241CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • S. Boriani
    • 1
    Email author
  • R. Ghermandi
    • 1
  • M. Girolami
    • 1
  • A. Gasbarrini
    • 1
  1. 1.Oncologic and Degenerative Spine Surgery DepartmentRizzoli Orthopedic InstituteBolognaItaly

Personalised recommendations