• Journal of Korean Neurosurgical Society
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• v.40 no.6
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• pp.471-475
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• 2006

Complete vertebral tumor resection is important in order to prevent local recurrence. Among the available techniques for total spondylectomy, the total en bloc spondylectomy has been accepted as the most sophisticated one. After a total en bloc spondylectomy, anterior and posterior column reconstruction is mandatory in order to achieve stability. We experienced the usefulness of an expandable cage for anterior column reconstruction especially in this surgery. The chance of cutting the nerve root and damaging the spinal cord is minimized because the size of the expandable cage is initially small enough to be inserted into the anterior column. The technical details of total vertebral body replacement with an expandable cage after an en bloc lumbar spondylectomy are described herein.

• Journal of Korean Neurosurgical Society
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• v.45 no.3
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• pp.188-191
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• 2009

The presence of distant metastases from differentiated thyroid carcinoma decreases the 10-year survival rates of patients by 50%. This is a report of a 61-year-old female with follicular thyroid carcinoma who presented initially with low back pain. 2-deoxy-2-[18F] fluoro-D-glucose whole-body positron emission tomography/computed tomography (PET/CT) demonstrated a hypointensity lesion in the left thyroid gland with malignant uptake in L1 vertebra and magnetic resonance images revealed paravertebral and epidural extension of mass in L1 vertebra. After thyroidectomy, histopathological study showed a follicular carcinoma. We performed L1 total en bloc spondylectomy with expandable cage for long-term local control. The technical details of total en bloc spondylectomy in follicular carcinoma are described herein.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.2
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• pp.148-154
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• 2006

Purpose: Numerous operations on primary and metastatic spinal tumor have been performed and among those total en bloc spondylectomy has produced decent clinical result, This article introduce 1 case of metastatic spine tumor of C3,C4 who treated with total en bloc spondylectomy.

• Journal of Korean Neurosurgical Society
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• v.56 no.5
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• pp.431-435
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• 2014

A fifty-year-old female non-smoker with no other specific medical history visited our institute. She complained of axial back pain with no other neurological deficit. Chest X-ray, chest computed tomography (CT) scan, CT-guided needle aspiration biopsy, whole-body positron emission tomography, spine CT and spine magnetic resonance image findings suggested NSCLC with epidermal growth factor receptor (EGFR) mutation, multiple brain metastases, and two isolated metastases to the T3 and L3 vertebral bodies. She underwent chemotherapy with gefitinib ($Iressa^{TM}$) for NSCLC and gamma knife surgery for multiple brain metastases. We performed a two-staged, total en bloc spondylectomy of the T3 and L3 vertebral bodies based on several good prognostic characteristics, such as the lack of metastases to the appendicular bone, good preoperative performance status, and being an excellent responder (Asian, never-smoker and adenocarcinoma histology) to EGFR inhibitors. Improved axial back pain after the surgery enabled her to walk with the aid of a thoracolumbosacral orthosis brace on the third postoperative day. Her Karnofsky performance status score (KPS) was 90 at the time of discharge and has been maintained to date 3 years after surgery. In selected NSCLC patients with good prognostic characteristics, we suggest that locally curative treatment such as total en bloc spondylectomy or radiosurgery should be emphasized to achieve longer term survival for the selected cases.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.37-42
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• 2007

Purpose: Because of the anatomical characteristics, it is difficult to perform radical operation in spinal tumor. Numerous operations on primary and metastatic spinal tumor have been performed and among those total en bloc spondylectomy has produced decent clinical result. Clinical and radiological results have been analyzed based on five total en bloc spondylectomy on primary and metastatic spinal tumor. Materials and Methods: Patients included in this study were one with primary and four with metastatic spinal tumors, from June 1997 to January 2006. Two of the four were originated form kidney. One was from breast and the other one was not identified. McAfee's 4 point scale, VAS and Frankel's classification have been used as clinical assessment of pain and neurological symptoms. Clinical assessment have been conducted for every 3 months after operation including local recurrence, bone union and complications. Results: Assessment of pain decreased from average of 3 before operation to 1.6 after operation in McAfee's scale and VAS decreased from average of 9.2 to 1.6. Neurological deficit after operation improved from C to D in Frankel's category. Local recurrence has been detected on metastatic adenocarcinoma of L4 during follow up. Conclusion: Total en bloc spondylectomy is evidently useful operational method for primary and metastatic spinal tumor since it completely decompresses spinal nerves, decreases axial pain immediately and improves the quality of remaining life.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.80-84
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• 2006

A combined anterolateral and posterior approach with thoracotomy has been recommended as the traditional surgical approach for the tumors of the thoracic spine. Recently, because of the morbidity associated with open thoracotomy, the thoracoscopically assisted surgical technique was introduced successfully in thoracic spinal surgery. Herein, we report a combined surgical technique for giant cell tumor of the thoracic spine (T10) consisting of bilateral thoracoscopic anterior release of the spine followed by a posterior on bloc spondylectomy and reconstruction by orthopedic surgeons. The thoracoscopic spinal surgery is safe and effective alternative for other open thoracotomic procedures in the approach to the anterior thoracic spine, avoiding the disadvantage inherent to thoracotomy.