Novel application of FiberWire for intervertebral disc transection in en bloc spondylectomy: a case report

Total en bloc spondylectomy (TES) is a complex surgical technique for treating aggressive primary spinal tumors, with the goal of achieving negative margins and minimizing recurrence. Threadwire saws have historically been used for disc transection during TES, but their discontinuation poses a logistical challenge. We present a case demonstrating the use of #5 FiberWire as a novel and effective alternative for disc transection during TES.

A 31-year-old female with a biopsy-confirmed L3 chordoma presented with lower back pain and left leg radiculopathy. Imaging revealed a localized lesion in the L3 vertebral body without pedicle or epidural involvement. She underwent a two-stage TES, during which #5 FiberWire was used in place of a traditional Tomita saw to perform disc transection. This technique enabled safe mobilization of the L3 vertebra while avoiding injury to the thecal sac. The patient tolerated the procedure well, with negative margins on pathology and no major complications postoperatively.

FiberWire, a high-tensile braided suture, was used successfully to achieve controlled disc cuts, serving as a feasible alternative to discontinued threadwire saws. Its flexibility and smooth surface allowed precise navigation around critical structures, preserving endplates and supporting spinal reconstruction. Proper case selection remains essential for the safe use of this technique. In the absence of threadwire saws, FiberWire may be considered a viable option for disc transection during TES in select cases. This technique offers a safe, low-cost, and widely available alternative that may help maintain oncologic and reconstructive goals in spine tumor surgery.