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Case Reports
. 2011 Jul;20 Suppl 2(Suppl 2):S202-5.
doi: 10.1007/s00586-010-1539-y. Epub 2010 Aug 9.

Thoracoscopic assisted en bloc resection of a spine tumor

Michele Cappuccio  1 , Alessandro Gasbarrini, Rakesh Donthineni, Rudolf Beisse, Stefano Boriani
Affiliations
Case Reports

Thoracoscopic assisted en bloc resection of a spine tumor

Michele Cappuccio et al. Eur Spine J. 2011 Jul.

Abstract

Spine tumors are fairly common and the management is through a multimodality approach. Lesions of the thoracic and lumbar vertebrae have been treated with such extensive anterior and/or posterior approaches. The authors present a case of a 56-year-old lady with solitary T11 metastases from colonic carcinoma and a case of a 43-year-old lady with T5-T6 high-grade osteogenic sarcoma. The treatment consists of a wide vertebrectomy by posterior approach, after anterior release and sub-pleural dissection using a thoracoscopic approach. A thoracoscopic assisted anterior approach could reduce the duration and the morbidity of a vertebrectomy without affecting oncological management.

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Figures

Fig. 1
Fig. 1
Axial CT showing the extension of the tumor into the right posterior elements, and relative sparing of the left side
Fig. 2
Fig. 2
Thoracoscopic view of the pleura that had been dissected around the T11 to be left as a patch of margin for the resection
Fig. 3
Fig. 3
The spinal cord within the dura is visible, and the resected vertebra is carefully manipulated around the cord for removal. A single posterior rod is applied to the opposite side (left) to stabilize the spine during the vertebral removal
Fig. 4
Fig. 4
Gross pathology of the resected vertebra
Fig. 5
Fig. 5
Postoperative X-ray
See this image and copyright information in PMC

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