All-posterior total en bloc spondylectomy for thoracic spinal tumors

Philip K. Louie, Jannat M. Khan, Ira Miller, Matthew W. Colman


Total en bloc spondylectomy (TES) involves disruption of the bony neural ring via bilateral pediculotomy and posterior en bloc laminectomy followed by the en bloc vertebrectomy. All-posterior TES allows for resection of malignant and benign aggressive spine tumors with minimal morbidity. The purpose of this report is to describe two cases of all-posterior spondylectomy using the recently developed Resegone retractor (K2M, Leesburg, VA, USA) which facilitates an all-posterior resection. The technique is well described and generally includes 3 major portions: a resection of the posterior elements with bilateral costotransversectomy, passage of threadwire saws anterior to the vertebral bodies, and en bloc resection of the anterior column. With the device in place, the sawing of the bone can be performed without risking pull-through into the cord, while cutting through the desired path in a smooth and parallel fashion.