Total Spondylectomy of a Lumber Vertebra with Giant Cell Tumor: One Case Report / 대한정형외과학회잡지

ABSTRACT

Giant cell tumor of the spine is regarded as a cllnically mallgnant tumor because of its difficulty in diagnosis, cord compression and its frequent recurrence. The consensus of current report on giant cell tumor is that local resection is the treatment of choice where it is feasible. In the spine, however, because of its inoperable location, irradiation has become an accepted mode of treatment, although the results of which are at best uncertain. Total spondylectomy Is a formidable undertaking and its report is scarce. In 1966, Lievre reported total spondylectomy of the fourth lumber vertebra. In 1968, Stener and Johnsen performed total spondylectomy of three vertebral bodies, the eleventh thoracic through the first lumbar. Recently, in the summer of 1979, Edwards reported prosthetic replacement after total spondylectomy. This report presents our experience with giant cell tumor of the thlrd lumbar vertebra, which was successively treated by an excislonal biopsy through anterior retroperitoneal approach, complete removal of the vertebral body and interbody fusion of the adjoining vertebrae through an anterior medlan transperitoneal approach, and finally by excislon of the remaining posterior elemsnt and a posterior H-graft supplimented by loop wire flxation. At six month follow-up, fusion was solid and there was no exidence of recurrence of the tumor.