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 an 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.