Chordoma in the Cervical Spine Managed With En Bloc Excision

STUDY DESIGN: En bloc resection of a chordoma in the midcervical vertebral spine was performed. OBJECTIVES: To document the surgical technique used for en bloc excision of a chordoma arising in the midcervical spine. SUMMARY OF BACKGROUND DATA: Malignant tumors arising in long bones are excised en bloc. The authors recently designed a technique for en bloc resection of malignant tumors in the thoracolumbar spine using the T-saw. However, this technique is difficult in tumors of the cervical spine, and there are no previous reports of successful en bloc resection of such tumors. METHODS: Using an anterior approach, the ipsilateral vertebral artery was ligated. This was followed by sharply cutting the pedicle of the cervical vertebra with a specially designed T-saw. RESULTS: En bloc excision of chordomas in the cervical spine was achieved using the T-saw. CONCLUSION: Although the surgical margin was intralesional in a small area, the technique used in this case study indicates that en bloc excision of such tumors can be used with a safety margin even in the cervical spine.