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Bone Sarcoma of the Spine

  • Chapter
Treatment of Bone and Soft Tissue Sarcomas

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 179))

Abstract

Primary malignant bone tumors of the vertebral column, i.e., bone sarcomas of the spine, are inherently rare entities. Vertebral osteosarcomas and chordomas represent the largest groups, followed by the incidence of chondro-, fibro-, and Ewing's sarcomas. Detailed clinical and neurological examination, complete radiographic imaging [radiographs, computed tomography (CT), magnetic resonance imaging (MRI)], and biopsy are the decisive diagnostic steps. Oncosurgical staging for spinal tumors can serve as a decision-guidance system for an individual's oncological and surgical treatment. Subsequent treatment decisions are part of an integrated, multimodal oncological concept. Surgical options comprise minimally invasive surgery, palliative stabilization procedures, and curative, wide excisions with complex reconstructions to attain wide or at least marginal resections. The most aggressive mode of surgical resection for primary vertebral column tumors is the total en bloc vertebrectomy, i.e., single-or multilevel en bloc spondylectomy. En bloc spondylectomy involves a posterior or combined anterior/posterior approach, followed by en bloc laminectomy, circumferential (360°) vertebral dissection, and blunt ventral release of the large vessels, intervertebral discectomy and rotation/ en bloc removal of the vertebra along its longitudinal axis. Due to the complex interdisciplinary approach and the challenging surgical resection techniques involved, management of vertebral bone sarcomas is recommended to be performed in specific musculoskeletal tumor centers.

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Authors and Affiliations

  1. Section for Musculoskeletal Tumor Surgery Center for Musculoskeletal Surgery, Charité University Medicine Berlin, Augustenburger Platz 1, Berlin, 13353, Germany

    A. Luzzati MD

  2. Div. Ortopedia e Traumatologia, Istituto Ospitalieri Cremona, Italy

    Klaus-Dieter Schaser MD, I. Melcher MD & A. C. Disch MD

Authors
  1. Klaus-Dieter Schaser MD
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  2. I. Melcher MD
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  3. A. Luzzati MD
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  4. A. C. Disch MD
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Editors and Affiliations

  1. Leiter Department Tumororthopädie Klinik für Orthopädie und Orthopädische Rheumatologie, HELIOS-Klinikum Berlin, Schwanebecker Chaussee 50, Berlin, 13125

    Per-Ulf Tunn

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Schaser, KD., Melcher, I., Luzzati, A., Disch, A.C. (2009). Bone Sarcoma of the Spine. In: Tunn, PU. (eds) Treatment of Bone and Soft Tissue Sarcomas. Recent Results in Cancer Research, vol 179. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77960-5_10

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  • DOI: https://doi.org/10.1007/978-3-540-77960-5_10

  • Publisher Name: Springer, Berlin, Heidelberg

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