Metastatic lesions account for majority spinal tumors. Primary spinal malignancies are rare, however, surgery in these tumours can be curative if performed with an en bloc technique. Intralesional excision of primary spinal tumor such as chordoma is associated with a 100% recurrence rate. Hence, it is important to know the histological diagnosis before embarking on surgical treatment for any spinal tumor. A surgeon will get only one chance to offer curative surgery in primary spinal malignancy and biopsy is extremely important to different such malignancies from the more common metastatic lesions.
Following is an excellent talk from the Seattle Science Foundation by Dr. Ehud Mendel, Professor of Neurosurgery at Ohio State University, Columbus, OH, on considerations for En Bloc resection for primary spinal tumors.