Metastatic lesions account for the majority of spinal tumors. Primary spinal malignancies are rare, however surgery in these tumors can be curative if performed with an en bloc technique. Intralesional excision of a 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 differentiate 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 of primary spinal tumors.