ABSTRACT
[Objective] To investigate the surgical treatments and outcomes of chordomas in the mobile spine.[Methods]A series of 15 cases of chordomas arising from the mobile spine which received surgical treatments were retrospectively reviewed.According to the WBB(Weinstein-Boriani-Biagini)surgical staging system,the tumours mainly occupied the vertebral body areas,ic,4 to 9 radiating zones in 7 cases,expanded outside to 4 or 9 radiating zone in 4 cases,both to 4 and 9 radiating zones in 4 cases.Thirteen of them affected A to D layers,the other 2 affected A to C layers.One vertebra was involved in 9 cases,two vertebrae were involved in 5 cases and 3 vertebrae in 1 case.Vertebrectomies or sagittal resections were performed in 10 cases and total spondylectomies in 5 cases.Four patients underwent posterior approach operations and 3 patients underwent anterior approach operations for spinal reconstruction and stabilization.Eight patients received combined anterior and posterior operations for spinal reconstruction and stabilization.Tricortical autogenions bone grafts,some in titanium mesh,were used for reconstruction in 9 patients.While mesh and bone cement were uesd in 6 patients.Local radiation therapies were performed in all patients after surgeries.[Results]Clinical symptoms and neurologic deficits were relived in all the patients.Fusion of the bone grafts was got in all the 9 cases.The follow-up was 14 to 123 months,average 56.2 months.Local-recurrence could be observed in 7 cases and 4 cases died.No metastasis was seen in this series.[Conclusion]Eearly diagnosis and treatment have great effects on the prognosis of the chordoma arising in mobile spine.Total spondylectomy with postoperative radiation therapy can decline the local-recurrent rate.