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Aggressive surgery for metastatic spinal tumors
Stéphane Fuentes1, Mikael Meyer1, Jean d'Artigues1
1Department of Neurosurgery and Spine Surgery, La Timone University Hospital, Assistance Publique des Hôpitaux de Marseille, France.
Neuro-Chirurgie
|March 22, 2026
Summary
En bloc resection for metastatic spinal tumors (MST) involves vertebrectomy, hemivertebrectomy, and corpectomy for complete tumor removal. Careful patient selection and surgical expertise are crucial for optimizing outcomes in these complex cases.
Area of Science:
- Oncology
- Neurosurgery
- Orthopedic Oncology
Background:
- Metastatic spinal tumors (MST) pose significant challenges in treatment.
- Aggressive surgical resection is a key component in managing selected MST cases.
Purpose of the Study:
- To outline the primary en bloc resection techniques for MST.
- To discuss the indications, surgical approaches, and critical factors for successful outcomes.
Main Methods:
- En bloc resection techniques including vertebrectomy, hemivertebrectomy, and corpectomy were reviewed.
- Surgical approaches (anterior, posterior, combined) and patient selection criteria were analyzed.
Main Results:
- En bloc excision aims for complete tumor removal with clear margins.
- Vertebrectomy, hemivertebrectomy, and corpectomy offer tailored approaches based on tumor location and extent.
- While effective in selected patients, en bloc vertebrectomy has high morbidity and may require revisions.
Conclusions:
- Multidisciplinary evaluation is essential for determining suitability for aggressive spinal tumor surgery.
- Patient selection, embolization, vascular support, and experienced surgical teams are paramount for optimizing management and outcomes.
