L4 and L5 spondylectomy for en bloc resection of giant cell tumor and review of the literature

Authors

• David R. Santiago-Dieppa, Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
• Lee S. Hwang, Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.Follow
• Ali Bydon, Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
• Ziya L. Gokaslan, Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
• Edward F. McCarthy, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
• Timothy F. Witham, Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.

Document Type

Article

Abstract

Study Design Case report and review of the literature. Objective We present the case of a two-level lumbar spondylectomy at L4 and L5 for en bloc resection of a giant cell tumor (GCT) and lumbopelvic reconstruction. Methods A 58-year-old woman presented with a 7-month history of progressive intractable back and leg pain secondary to a biopsy-proven Enneking stage III GCT of the L4 and L5 vertebrae. The patient underwent a successful L4-L5 spondylectomy and lumbopelvic reconstruction using a combined posterior and anterior approach over two operative stages. Results Postoperative complications included a deep wound infection and a cerebrospinal fluid leak; however, following surgical debridement and long-term antibiotic treatment, the patient was neurologically intact with minimal pain and there was no evidence of tumor recurrence or instrumentation failure at more than 2 years of follow-up. Conclusion Spondylectomy that achieves en bloc resection is a viable and effective treatment option that can be curative for Enneking stage III GCTs involving the lower lumbar spine. The lumbosacral junction represents a challenging anatomic location for spinal reconstruction after spondylectomy with unique technical considerations.

Publication Date

10-1-2014

Publication Title

Evidence-based spine-care journal

ISSN

1663-7976

Volume

5

Issue

2

First Page

151

Last Page

7

PubMed ID

25364329

Digital Object Identifier (DOI)

10.1055/s-0034-1387804

Recommended Citation

Santiago-Dieppa, David R.; Hwang, Lee S.; Bydon, Ali; Gokaslan, Ziya L.; McCarthy, Edward F.; and Witham, Timothy F., "L4 and L5 spondylectomy for en bloc resection of giant cell tumor and review of the literature" (2014). Neurosurgery. 2315.
https://scholar.barrowneuro.org/neurosurgery/2315