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Updated: Jan 29, 2026

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
FOUR-LEVEL EN BLOC VERTEBRECTOMY: A NOVEL TECHNIQUE AND LITERATURE REVIEW
Douglas Kenji Narazaki1, Lucas P Higino1, William Gemio Jacobsen Teixeira1
1Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), Instituto de Ortopedia e Traumatología, Spine Surgery Division, Spinal Tumors, São Paulo, SP Brazil.
Objective:
To demonstrate a novel technique for multilevel en bloc post-vertebrectomy reconstruction.
Methods:
A novel technique for en bloc multiple post-vertebrectomy reconstruction was used in a patient presenting for curative resection of Ewing's Sarcoma at the oncology center of a public university hospital.
Results:
The procedure described was feasible for en bloc resection of the four vertebrae. The reconstruction was acceptable and satisfactory in terms of mechanical stability and was without any neurological sequelae in the patient.
Conclusion:
The use of an allograft with a locked intramedullary nail was an adequate solution for reconstructing the anterior and medial spines after multilevel vertebrectomy. In addition, the association of four intramedullary nails provided stability to the reconstruction. Immediate benefits of the technique compared to other commonly used techniques were shorter hospitalization times and reduced surgical morbidity.
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