Primary Bone Tumors of the Spine: Surgical Management

Surgical management of primary bone tumors of the spine, whether malignant or benign, requires a good preoperative analysis with staging according to recently updated systems. The surgical planning must take into account the risk-benefit ratio for the patient and skill level of the surgical team. En bloc vertebrectomy seems to be correlated with the best prognosis whether for malignant or benign tumors; however, invasion of the spinal canal or large vessels makes this surgery too aggressive and illusory. Advances in chemotherapy modalities and new radiotherapy techniques are particularly important in case of incomplete resection in reducing the risk of recurrence. Osteosynthesis and reconstruction of the frontal and sagittal balance of the spine after tumor resection have benefited from the evolution of instrumentation in spinal surgery.