Three-level en bloc spondylectomy for chordoma

Background: En bloc resection of spinal and sacral chordomas may convey a survival benefit. However, these procedures often are complex and require the surgeon to plan a procedure that results in negative tumor margins, protects vital neurovascular structures, and concludes with a viable biomechanical reconstruction. Objective: We present a case of a 3-level en bloc lumbar spondylectomy and reconstruction. Methods: A case of a 45-year-old woman with biopsy-proven exophytic L4 chordoma is presented. The patient underwent successful L3-L5 en bloc spondylectomy and reconstruction over 3 stages. Results: The patient did well following the procedure, and was neurologically intact at 6-week follow-up. Conclusion: Three-level en bloc spondylectomy with lumbopelvic reconstruction is a challenging yet feasible procedure.