Thoracoscopically assisted total en bloc spondylectomy: two case reports

We describe a combined surgical technique for tumors of the thoracic spine consisting of a thoracoscopically assisted ventral release followed by a dorsal en bloc spondylectomy and reconstruction. The technique enables thoracoscopic access and release of the involved spinal segment(s) to achieve surgical and histopathologic wide margins, avoiding the disadvantages inherent to thoracotomy. Two patients were successfully treated with solitary tumors involving T10 and T7-8 vertebra. The resection margins were free of tumor. Thoracoscopically assisted total en bloc spondylectomy allows wide excision of thoracic spinal tumors with free resection margins in selected patients; the operation can be performed under direct vision without contamination of uninvolved parts.