En Bloc Resection of Thoracic and Upper Lumbar Spinal Tumors Using a Novel Rotation-Reversion Technique through...

Area of Science:

• Neurosurgery
• Orthopedic Oncology
• Spinal Surgery

Background:

• En bloc resection is standard for spinal tumors but often requires complex anterior-posterior approaches.
• Combined approaches lead to longer surgeries, increased blood loss, and greater trauma.
• A posterior-only approach could mitigate these challenges.

Purpose of the Study:

• To describe a novel rotation-reversion technique for posterior-only en bloc resection of thoracic and upper lumbar spinal tumors.
• To evaluate the safety and efficacy of this technique.

Main Methods:

• Retrospective review of 13 patients with thoracic and upper lumbar (L1-L3) spinal tumors treated between 2015 and 2023.
• En bloc resection performed using the rotation-reversion technique via a posterior-only approach.
• Analysis of clinical characteristics and surgical outcomes.

Main Results:

• Successful posterior-only en bloc resection in all 13 patients.
• Median follow-up of 30.4 months; negative margins achieved in 100%.
• Mean operative time 458.5 minutes, mean blood loss 3,146.2 mL; 30.8% experienced perioperative complications. One local recurrence and one instrumentation failure observed.

Conclusions:

• The rotation-reversion technique is a safe and effective posterior-only approach for selected thoracic and upper lumbar spinal tumors.
• This method facilitates en bloc resection, potentially reducing surgical morbidity.
• Achieving negative margins and acceptable oncological outcomes is feasible with this technique.