The role of en bloc resection in the modern era for primary spine tumors Review


Authors: Yeung, C. M.; Bilsky, M.; Boland, P. J.; Vaynrub, M.
Review Title: The role of en bloc resection in the modern era for primary spine tumors
Abstract: Study Design. A literature review. Objective. The aim of this review is to provide an overview of benign and malignant primary spine tumors and a balanced analysis of the benefits and limitations of (and alternatives to) surgical treatment with en bloc resection. Summary of Background Data. Primary spine tumors are rare but have the potential to cause severe morbidity, either from the disease itself or as a result of treatment. The prognosis, goals, and treatment options vary significantly with the specific disease entity. Appropriate initial management is critical; inappropriate surgery before definitive treatment can lead to recurrence and may render the patient incurable, as salvage options are often inferior. Methods. We performed a comprehensive search of the PubMed database for articles relevant to primary spine neoplasms and en bloc spine surgery. Institutional review board approval was not needed. Results. Although Enneking-appropriate en bloc surgery can be highly morbid, it often provides the greatest chance for local control and/or patient survival. However, there is growing data to support modern radiotherapy as a feasible and less morbid approach to certain primary neoplasms that historically were considered radioresistant. Conclusions. Choosing the optimal approach to primary spine tumors is complex. A comprehensive and up-to-date assessment of the evidence is required to guide patient care and to balance the often-competing goals of prolonging life and preserving quality of life. © 2024 Lippincott Williams and Wilkins. All rights reserved.
Keywords: osteosarcoma; treatment outcome; allograft; cancer staging; outcome assessment; quality of life; neoplasm recurrence, local; morbidity; ewing sarcoma; gene rearrangement; tumors; tumor recurrence; spinal cord tumor; spine; spinal neoplasms; surgery; resection; chondrosarcoma; salvage; chordoma; radiofrequency; fibula graft; desmoplastic small round cell tumor; spine surgery; spine tumor; en bloc resection; laminectomy; giant cell tumor of bone; vertebra body; osteoblastoma; aneurysmal bone cyst; arthrodesis; osteoid osteoma; sacrectomy; benign neoplasm; osteoclastoma; humans; prognosis; human; article; en bloc; nerve root; enneking staging; facetectomy; open biopsy; posterior longitudinal ligament
Journal Title: Spine
Volume: 49
Issue: 1
ISSN: 0362-2436
Publisher: Lippincott Williams & Wilkins  
Date Published: 2024-01-01
Start Page: 46
End Page: 57
Language: English
DOI: 10.1097/brs.0000000000004821
PUBMED: 37732462
PROVIDER: scopus
PMCID: PMC10750970
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Max Vaynrub -- Source: Scopus
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MSK Authors
  1. Patrick J Boland
    160 Boland
  2. Mark H Bilsky
    319 Bilsky
  3. Maksim Vaynrub
    36 Vaynrub
  4. Caleb Matthew Yeung
    5 Yeung