Skip to main content

Spinal Cord and Nerve Root Decompression

  • Chapter
Cancer in the Spine

Part of the book series: Current Clinical Oncology ((CCO))

  • 1128 Accesses

Abstract

Tumors of the vertebral column include both primary and metastatic lesions. These tumors can cause significant morbidity consisting of lesional pain and pain from deformity. Compression of the spinal cord and spinal nerve roots can also cause radicular pain as well as neurologial deterioration including sensory deficits, weakness, paralysis, and/or sexual/bowel/ bladder dysfunction. In cases of metastatic lesions, the spine is the most common region of osseous involvement (1). Metastatic vertebral spine lesions can result in pathological fractures or have significant epidural tumor involvement, both of which can lead to neurological deterioration (2). Mortality and morbidity can be significant in malignant tumors and overall treatment is best addressed by a multidisciplinary approach.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Gokaslan ZL. Spine surgery for cancer. Curr Opin Oncol 1996; 8:178–181.

    PubMed  CAS  Google Scholar 

  2. Klimo K, Kestle JRW, Schmidt MH. Treatment of metastatic spinal epidural disease: a review of the literature. Neurosurg Focus 2003; 15:1–9.

    Google Scholar 

  3. Gilbert RW, Kim JH, Posner JB. Epidural spinal cord compression from metastatic tumor: diagnosis and treatment. Ann Neurol 1978; 3:40–51.

    Article  PubMed  CAS  Google Scholar 

  4. Young RF, Post EM, King GA. Treatment of spinal epidural metastases. Randomized prospective comparison of laminectomy and radiotherapy. J Neurosurg 1980; 53:741–748.

    Article  PubMed  CAS  Google Scholar 

  5. Dahlbeck S, Kagan AR. Spinal cord compression, infection, and unknown primary cancers. Am J Clin Oncol 2001; 24:315–318.

    Article  PubMed  CAS  Google Scholar 

  6. Ratliff JK, Cooper PR. Metastatic spine tumors. South Med J 2004; 97:246–253.

    Article  PubMed  Google Scholar 

  7. Durr HR, Wegener B, Krodel A, Muller PE, Jansson V, Refior HJ. Multiple myeloma: surgery of the spine: retrospective analysis of 27 patients. Spine 2002; 27:320–324.

    Article  PubMed  Google Scholar 

  8. Sundaresan N, Rothman A, Manhart K, Kelliher K. Surgery for solitary metastases of the spine: rationale and results of treatment. Spine 2002; 27:1802–1806.

    Article  PubMed  Google Scholar 

  9. Ghogawala Z, Mansfield FL, Borges LF. Spinal radiation before surgical decompression adversely affects outcomes of surgery for symptomatic metastatic spinal cord compression. Spine 2001; 26:818–824.

    Article  PubMed  CAS  Google Scholar 

  10. Gokaslan ZL, York JE, Walsh GL, et al. Transthoracic vertebrectomy for metastatic spinal tumors. J Neurosurg 1998; 89:599–609.

    PubMed  CAS  Google Scholar 

  11. Cooper PR, Errico TJ, Martin R, Crawford B, DiBartolo T. A systematic approach to spinal reconstruction after anterior decompression for neoplastic disease of the thoracic and lumbar spine. Neurosurgery 1993; 32:1–8.

    Article  PubMed  CAS  Google Scholar 

  12. Walsh GL, Gokaslan ZL, McCutcheon IE, et al. Anterior approaches to the thoracic spine in patients with cancer: indications and results. Ann Thorac Surg 1997; 64:1611–1618.

    Article  PubMed  CAS  Google Scholar 

  13. Fourney DR, Abi-Said D, Rhines LD, et al. Simultaneous anteriorposterior approach to the thoracic and lumbar spine for the radical resection of tumors followed by reconstruction and stabilization. J Neurosurg 2001; 94:232–244.

    PubMed  CAS  Google Scholar 

  14. Yao KC, Boriani S, Gokaslan ZL, Sundaresan N. En bloc spondylectomy for spinal metastases: a review of techniques. Neurosurg Focus 2003; 15:1–5.

    Article  Google Scholar 

  15. Regine WF, Tibbs PA, Young A, et al. Metastatic spinal cord compression: a randomized trial of direct decompressive surgical resection plus radiotherapy vs. radiotherapy alone. Int J Radiat Oncol Biol Phys 2003; 57:S125.

    Google Scholar 

  16. Parikh SN, Crawford AH. Orthopaedic implications in the management of pediatric vertebral and spinal cord tumors: a retrospective review. Spine 2003; 28:2390–2396.

    Article  PubMed  Google Scholar 

  17. Raskas DS, Graziano GP, Herzenberg JE, Heidelberger KP, Hensinger RN. Osteoid osteoma and osteoblastoma of the spine. J Spinal Disord 1992; 5:204–211.

    Article  PubMed  CAS  Google Scholar 

  18. Jallo GI, Kothbauer KF, Epstein FJ. Intrinsic spinal cord tumor resection. Neurosurgery 2001; 49:1124–1128.

    Article  PubMed  CAS  Google Scholar 

  19. Roonprapunt C, Silvera VM, Setton A, Freed D, Epstein FJ, Jallo GI. Surgical management of isolated hemangioblastomas of the spinal cord. Neurosurgery 2001; 49:321–327.

    Article  PubMed  CAS  Google Scholar 

  20. Lonstein JE. Post-laminectomy kyphosis. Clin Orthop 1977:93–100.

    Google Scholar 

  21. Otsuka NY, Hey L, Hall JE. Postlaminectomy and postirradiation kyphosis in children and adolescents. Clin Orthop 1998:189–194.

    Google Scholar 

  22. Freiberg AA, Graziano GP, Loder RT, Hensinger RN. Metastatic vertebral disease in children. J Pediatr Orthop 1993; 13:148–153.

    PubMed  CAS  Google Scholar 

  23. York JE, Gokaslan ZL. Craniocervical junction neoplastic conditions. Seminars in Neurosurgery 2002:145–150.

    Google Scholar 

  24. Bilsky MH, Shannon FJ, Sheppard S, Prabhu V, Boland PJ. Diagnosis and management of a metastatic tumor in the atlantoaxial spine. Spine 2002; 27:1062–1069.

    Article  PubMed  Google Scholar 

  25. Phillips E, Levine AM. Metastatic lesions of the upper cervical spine. Spine 1989; 14:1071–1077.

    Article  PubMed  CAS  Google Scholar 

  26. Schaeren S, Jeanneret B. Occipitocervical Instrumentation. Tech Orthop 2002; 17:287–295.

    Article  Google Scholar 

  27. Crockard HA. Anterior approaches to lesions of the upper cervical spine. Clin Neurosurg 1988; 34:389–416.

    PubMed  CAS  Google Scholar 

  28. Schmelzle R, Harms J. [Craniocervical junction-diseases, diagnostic application of imaging procedures, surgical technics]. Fortschr Kiefer Gesichtschir 1987; 32:206–208.

    PubMed  CAS  Google Scholar 

  29. Sar C, Eralp L. Transoral resection and reconstruction for primary osteogenic sarcoma of the second cervical vertebra. Spine 2001; 26:1936–1941.

    Article  PubMed  CAS  Google Scholar 

  30. Bongioanni F, Assadurian E, Polivka M, George B. Aneurysmal bone cyst of the atlas: operative removal through an anterolateral approach. A case report. J Bone Joint Surg Am 1996; 78:1574–1547.

    PubMed  CAS  Google Scholar 

  31. McAfee PC, Bohlman HH, Riley LH Jr., Robinson RA, Southwick WO, Nachlas NE. The anterior retropharyngeal approach to the upper part of the cervical spine. J Bone Joint Surg Am 1987; 69:1371–1383.

    PubMed  CAS  Google Scholar 

  32. Kratimenos GP, Crockard HA. The far lateral approach for ventrally placed foramen magnum and upper cervical spine tumours. Br J Neurosurg 1993; 7:129–140.

    Article  PubMed  CAS  Google Scholar 

  33. Harms J, Melcher RP. Posterior C1–C2 fusion with polyaxial screw and rod fixation. Spine 2001; 26:2467–2471.

    Article  PubMed  CAS  Google Scholar 

  34. Magerl F, Seemann PS. Stable posterior fusion of the atlas and axis by transarticular screw fixation. New York, NY: Springer-Verlag; 1986.

    Google Scholar 

  35. Brooks AL, Jenkins EB. Atlanto-axial arthrodesis by the wedge compression method. J Bone Joint Surg Am 1978; 60:279–284.

    PubMed  CAS  Google Scholar 

  36. Simmons E. Alternatives in the surgical stabilization for the upper cervical spine. In: Tator CH, ed. Early Management of Acute Spinal Cord Injury. New York, NY: Raven; 1982:393–434.

    Google Scholar 

  37. Sonntag VKH, Dickman CA. Posterior atlantoaxial wiring techniques. In: Dickman CA, Spetzler RF, Sonntag VKH, eds. Surgery of the Craniovertebral Junction. New York, NY: Thieme; 1997:783–794.

    Google Scholar 

  38. Wright N. Posterior C2 Fixation Using Bilateral, Crossing C2 Laminar Screws. J Spinal Disord 2004; 17:158–162.

    Article  Google Scholar 

  39. Melcher RP, Puttlitz CM, Kleinstueck FS, Lotz JC, Harms J, Bradford DS. Biomechanical testing of posterior atlantoaxial fixation techniques. Spine 2002; 27:2435–2440.

    Article  PubMed  Google Scholar 

  40. Henriques T, Cunningham BW, Olerud C, et al. Biomechanical comparison of five different atlantoaxial posterior fixation techniques. Spine 2000; 25:2877–2883.

    Article  PubMed  CAS  Google Scholar 

  41. Dickman CA, Crawford NR, Paramore CG. Biomechanical characteristics of C1–2 cable fixations. J Neurosurg 1996; 85:316–322.

    PubMed  CAS  Google Scholar 

  42. Puttlitz CM, Melcher RP, Kleinstueck FS, Harms J, Bradford DS, Lotz JC. Stability analysis of craniovertebral junction fixation techniques. J Bone Joint Surg Am 2004; 86:561–568.

    PubMed  Google Scholar 

  43. Coyne TJ, Fehlings MG, Wallace MC, Bernstein M, Tator CH. C1-C2 posterior cervical fusion: long-term evaluation of results and efficacy. Neurosurgery 1995; 37:688–692.

    Article  PubMed  CAS  Google Scholar 

  44. Dickman CA, Sonntag VK. Surgical management of atlantoaxial nonunions. J Neurosurg 1995; 83:248–253.

    PubMed  CAS  Google Scholar 

  45. Stillerman CB, Wilson JA. Atlanto-axial stabilization with posterior transarticular screw fixation: technical description and report of 22 cases. Neurosurgery 1993; 32:948–954.

    Article  PubMed  CAS  Google Scholar 

  46. Asazuma T, Toyama Y, Maruiwa H, Fujimura Y, Hirabayashi K. Surgical strategy for cervical dumbbell tumors based on a threedimensional classification. Spine 2004; 29:E10–E144.

    Article  PubMed  Google Scholar 

  47. Robinson RA, Smith GW. Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull John Hopkins Hosp 1955; 96:223–224.

    Google Scholar 

  48. Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg 1958; 15:602–617.

    PubMed  CAS  Google Scholar 

  49. Eleraky MA, Llanos C, Sonntag VK. Cervical corpectomy: report of 185 cases and review of the literature. J Neurosurg 1999; 90:35–41.

    PubMed  CAS  Google Scholar 

  50. Narotam PK, Pauley SM, McGinn GJ. Titanium mesh cages for cervical spine stabilization after corpectomy: a clinical and radiological study. J Neurosurg 2003; 99:172–180.

    PubMed  Google Scholar 

  51. Dorai Z, Morgan H, Coimbra C. Titanium cage reconstruction after cervical corpectomy. J Neurosurg 2003; 99:3–7.

    PubMed  Google Scholar 

  52. Majd ME, Vadhva M, Holt RT. Anterior cervical reconstruction using titanium cages with anterior plating. Spine 1999; 24:1604–1610.

    Article  PubMed  CAS  Google Scholar 

  53. DeWald RL, Bridwell KH, Prodromas C, Rodts MF. Reconstructive spinal surgery as palliation for metastatic malignancies of the spine. Spine 1985; 10:21–26.

    Article  PubMed  CAS  Google Scholar 

  54. Miller DJ, Lang FF, Walsh GL, Abi-Said D, Wildrick DM, Gokaslan ZL. Coaxial double-lumen methylmethacrylate reconstruction in the anterior cervical and upper thoracic spine after tumor resection. J Neurosurg 2000; 92:181–190.

    PubMed  CAS  Google Scholar 

  55. Liu JK, Apfelbaum RI, Chiles BW, Schmidt MH. Cervical spinal metastasis: anterior reconstruction and stabilization techniques after tumor resection. Neurosurg Focus 2003; 15:1–7.

    Google Scholar 

  56. Pluta RM, Iuliano B, DeVroom HL, Nguyen T, Oldfield EH. Comparison of anterior and posterior surgical approaches in the treatment of ventral spinal hemangioblastomas in patients with von Hippel-Lindau disease. J Neurosurg 2003; 98:117–124.

    PubMed  Google Scholar 

  57. O’Toole JE, McCormick PC. Midline ventral intradural schwannoma of the cervical spinal cord resected via anterior corpectomy with reconstruction: technical case report and review of the literature. Neurosurgery 2003; 52:1482–1485.

    Article  PubMed  Google Scholar 

  58. Coumans JV, Marchek CP, Henderson FC. Use of the telescopic plate spacer in treatment of cervical and cervicothoracic spine tumors. Neurosurgery 2002; 51:417–424.

    Article  PubMed  Google Scholar 

  59. Walker MP, Yaszemski MJ, Kim CW, Talac R, Currier BL. Metastatic Disease of the Spine: Evaluation and Treatment. Clin Orthop 2003; 1:S165–S175.

    Google Scholar 

  60. Brown JA, Havel P, Ebraheim N, Greenblatt SH, Jackson WT. Cervical stabilization by plate and bone fusion. Spine 1988; 13:236–240.

    Article  PubMed  CAS  Google Scholar 

  61. Sundaresan N, Steinberger AA, Moore F, et al. Indications and results of combined anterior-posterior approaches for spine tumor surgery. J Neurosurg 1996; 85:438–446.

    PubMed  CAS  Google Scholar 

  62. McAfee PC, Bohlman HH. One-stage anterior cervical decompression and posterior stabilization with circumferential arthrodesis. A study of twenty-four patients who had a traumatic or a neoplastic lesion. J Bone Joint Surg Am 1989; 71:78–88.

    PubMed  CAS  Google Scholar 

  63. McAfee PC, Bohlman HH, Ducker TB, Zeidman SM, Goldstein JA. One-stage anterior cervical decompression and posterior stabilization. A study of one hundred patients with a minimum of two years of follow-up. J Bone Joint Surg Am 1995; 77:1791–1800.

    PubMed  CAS  Google Scholar 

  64. Schultz KD Jr, McLaughlin MR, Haid RW Jr, Comey CH, Rodts GE Jr, Alexander J. Single-stage anterior-posterior decompression and stabilization for complex cervical spine disorders. J Neurosurg 2000; 93:214–221.

    PubMed  Google Scholar 

  65. Le H, Balabhadra R, Park J. Surgical treatment of tumors involving the cervicothoracic junction. Neurosurg Focus 2003; 15:1–7.

    Google Scholar 

  66. Bellabarba C, Nemacek AN, Chapman JR. Management of Injuries to the Cervicothoracic Junction. Tech Orthop 2002; 17:355–364.

    Article  Google Scholar 

  67. Fielding JW, Stillwell WT. Anterior cervical approach to the upper thoracic spine. Spine 1976; 1:158–161.

    Article  Google Scholar 

  68. Gieger M, Roth PA, Wu JK. The anterior cervical approach to the cervicothoracic junction. Neurosurgery 1995; 37:704–709.

    Article  PubMed  CAS  Google Scholar 

  69. Luk KD, Cheung KM, Leong JC. Anterior approach to the cervicothoracic junction by unilateral or bilateral manubriotomy. A report of five cases. J Bone Joint Surg Am 2002; 84:1013–1017.

    PubMed  Google Scholar 

  70. Le Huec JC, Lesprit E, Guibaud JP, Gangnet N, Aunoble S. Minimally invasive endoscopic approach to the cervicothoracic junction for vertebral metastases: report of two cases. Eur Spine J 2001; 10:421–426.

    Article  PubMed  Google Scholar 

  71. Nazzaro JM, Arbit E, Burt M. “Trap door” exposure of the cervicothoracic junction. Technical note. J Neurosurg 1994; 80:338–341

    PubMed  CAS  Google Scholar 

  72. Korst RJ, Burt ME. Cervicothoracic tumors: results of resection by the “hemi-clamshell” approach. J Thorac Cardiovasc Surg 1998; 115:286–294

    Article  PubMed  CAS  Google Scholar 

  73. Kubo T, Nakamura H, Yamano Y. Transclavicular approach for a large dumbbell tumor in the cervicothoracic junction. J Spinal Disord 2001; 14:79–83.

    Article  PubMed  CAS  Google Scholar 

  74. Birch R, Bonney G, Marshall RW. A surgical approach to the cervicothoracic spine. J Bone Joint Surg Br 1990; 72:904–907.

    PubMed  CAS  Google Scholar 

  75. McLain RF, Lieberman IH. Endoscopic approaches to metastatic thoracic disease. Spine 2000; 25:1855–1858.

    Article  PubMed  CAS  Google Scholar 

  76. McLain RF. Endoscopically assisted decompression for metastatic thoracic neoplasms. Spine 1998; 23:1130–1135.

    Article  PubMed  CAS  Google Scholar 

  77. Wolfla CE, Maiman DJ. Lateral extracavitary approach. Tech Neurosurg 2003; 8.

    Google Scholar 

  78. Larson SJ, Holst RA, Hemmy DC, Sances A Jr. Lateral extracavitary approach to traumatic lesions of the thoracic and lumbar spine. J Neurosurg 1976; 45:628–637.

    PubMed  CAS  Google Scholar 

  79. Fessler RG, Dietze DD Jr, Millan MM, Peace D. Lateral parascapular extrapleural approach to the upper thoracic spine. J Neurosurg 1991; 75:349–355.

    PubMed  CAS  Google Scholar 

  80. Weller SJ, Rossitch E Jr. Unilateral posterolateral decompression without stabilization for neurological palliation of symptomatic spinal metastasis in debilitated patients. J Neurosurg 1995; 82:739–744.

    Article  PubMed  CAS  Google Scholar 

  81. Wiggins GC, Mirza S, Bellabarba C, et al. Perioperative complications with costotransversectomy and anterior approaches to thoracic and thoracolumbar tumors. Neurosurg Focus 2001; 11:1–9.

    Article  Google Scholar 

  82. Mazel Ch, Grunenwald D, Laudrin P, Marmorat JL. Radical excision in the management of thoracic and cervicothoracic tumors involving the spine: results in a series of 36 cases. Spine 2003; 28:782–792.

    Article  PubMed  Google Scholar 

  83. Mazel C, Hoffmann E, Antonietti P, Grunenwald D, Henry M, Williams J. Posterior cervicothoracic instrumentation in spine Tumors. Spine 2004; 29:1246–1253.

    Article  PubMed  Google Scholar 

  84. Siegal T. Surgical decompression of anterior and posterior malignant epidural tumors compressing the spinal cord: a prospective study. Neurosurgery 1985; 17:424–432.

    Article  PubMed  CAS  Google Scholar 

  85. Siegal T, Tiqva P. Vertebral body resection for epidural compression by malignant tumors. Results of forty-seven consecutive operative procedures. J Bone Joint Surg Am 1985; 67:375–382.

    PubMed  CAS  Google Scholar 

  86. Sundaresan N, Galicich JH, Lane JM, Bains MS, McCormack P. Treatment of neoplastic epidural cord compression by vertebral body resection and stabilization. J Neurosurg 1985; 63:676–684.

    PubMed  CAS  Google Scholar 

  87. Bianchi C, Ballard JL, Abou-Zamzam AM, Teruya TH, Abu-Assal ML. Anterior retroperitoneal lumbosacral spine exposure: operative technique and results. Ann Vasc Surg 2003; 17:137–142.

    Article  PubMed  Google Scholar 

  88. Bergey DL, Villavicencio AT, Goldstein T, Regan JJ. Endoscopic lateral transpsoas approach to the lumbar spine. Spine 2004; 29:1681–1688.

    Article  PubMed  Google Scholar 

  89. Regan JJ, Guyer RD. Endoscopic techniques in spinal surgery. Clin Orthop 1997:122–139.

    Google Scholar 

  90. Onimus M, Papin P, Gangloff S. Extraperitoneal approach to the lumbar spine with video assistance. Spine 1996; 21:2491–2494.

    Article  PubMed  CAS  Google Scholar 

  91. Khoo LT, Beisse R, Potulski M. Thoracoscopic-assisted treatment of thoracic and lumbar fractures: a series of 371 consecutive cases. Neurosurgery 2002; 51:104–117.

    Google Scholar 

  92. McAfee PC, Regan JR, Fedder IL, Mack MJ, Geis WP. Anterior thoracic corpectomy for spinal cord decompression performed endoscopically. Surg Laparosc Endosc 1995; 5:339–348.

    PubMed  CAS  Google Scholar 

  93. Konno S, Yabuki S, Kinoshita T, Kikuchi S. Combined laminectomy and thoracoscopic resection of dumbbell-type thoracic cord tumor. Spine 2001; 26:E130–E134.

    Article  PubMed  CAS  Google Scholar 

  94. Citow JS, Macdonald RL, Ferguson MK. Combined laminectomy and thoracoscopic resection of a dumbbell neurofibroma: technical case report. Neurosurgery 1999; 45:1263–1265.

    Article  PubMed  CAS  Google Scholar 

  95. Dvorak MF, Kwon BK, Fisher CG, Eiserloh HL 3rd, Boyd M, Wing PC. Effectiveness of titanium mesh cylindrical cages in anterior column reconstruction after thoracic and lumbar vertebral body resection. Spine 2003; 28:902–908.

    Article  PubMed  Google Scholar 

  96. Buttermann GR, Glazer PA, Bradford DS. The use of bone allografts in the spine. Clin Orthop 1996:75–85.

    Google Scholar 

  97. Cotler HB, Cotler JM, Stoloff A, et al. The use of autografts for vertebral body replacement of the thoracic and lumbar spine. Spine 1985; 10:748–756.

    Article  PubMed  CAS  Google Scholar 

  98. Errico TJ, Cooper PR. A new method of thoracic and lumbar body replacement for spinal tumors: technical note. Neurosurgery 1993; 32:678–680.

    Article  PubMed  CAS  Google Scholar 

  99. McCormick PC. Surgical management of dumbbell and paraspinal tumors of the thoracic and lumbar spine. Neurosurgery 1996; 38:67–74.

    Article  PubMed  CAS  Google Scholar 

  100. Akeyson EW, McCutcheon IE. Single-stage posterior vertebrectomy and replacement combined with posterior instrumentation for spinal metastasis. J Neurosurg 1996; 85:211–220.

    Article  PubMed  CAS  Google Scholar 

  101. Bilsky MH, Boland P, Lis E, Raizer JJ, Healey JH. Single-stage posterolateral transpedicle approach for spondylectomy, epidural decompression, and circumferential fusion of spinal metastases. Spine 2000; 25:2240–2249.

    Article  PubMed  CAS  Google Scholar 

  102. Tomita K, Kawahara N, Baba H, Tomita K, Kawahara N, Baba H. Total en bloc spondylectomy for solitary spinal metastases. Int Orthop 1994; 18:291–298.

    Article  PubMed  CAS  Google Scholar 

  103. 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 1997; 22:324–333.

    Article  PubMed  CAS  Google Scholar 

  104. Sakaura H, Hosono N, Mukai Y, Ishii T, Yonenobu K, Yoshikawa H. Outcome of total en bloc spondylectomy for solitary metastasis of the thoracolumbar spine. J Spinal Disord Tech 2004; 17:297–300.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Humana Press, Inc., Totowa, NJ

About this chapter

Cite this chapter

Lodhia, K.R., Park, P., Graziano, G.P. (2006). Spinal Cord and Nerve Root Decompression. In: McLain, R.F., Lewandrowski, KU., Markman, M., Bukowski, R.M., Macklis, R., Benzel, E.C. (eds) Cancer in the Spine. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-59259-971-4_29

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-971-4_29

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-074-8

  • Online ISBN: 978-1-59259-971-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics