Release notes of Primary tumors

The first edition was created by Nicolas Dea (Canada), and Jeremy Reynolds (UK), with Luiz Vialle (Brazil) as editor.

The Primary tumors module includes a detailed description of the following tumor types and their management.

Benign tumors (Osteoid osteoma, Osteoblastoma, Giant cell tumors, Aneurysmal bone cyst, Hemangioma)

C1–C7:

• Observation and analgesics
• Chemotherapy
• Radiofrequency ablation
• Percutaneous treatment (embolization)
• Radiation therapy
• Intralesional resection (C0–C2)
• Intralesional resection (C3–C7)
• En bloc resection of an anterior tumor (C1–C7)
• En bloc resection of a posterior tumor (C1–C7)

T1–T12

• Observation and analgesics
• Chemotherapy
• Radiofrequency ablation
• Percutaneous treatment (embolization)
• Radiation therapy
• Intralesional resection (L1–L5)
• En bloc resection with posterior release and anterior tumor delivery (L1–L5)
• En bloc resection of a posterior tumor (L1–L5)

L1–L5:

• Observation and analgesics
• Chemotherapy
• Radiofrequency ablation
• Percutaneous treatment (embolization)
• Radiation therapy
• Intralesional resection (L1–L5)
• En bloc resection with posterior release and anterior tumor delivery (L1–L5)
• En bloc resection of a posterior tumor (L1–L5)

S1–S5:

• Observation and analgesics
• Chemotherapy
• Radiofrequency ablation
• Percutaneous treatment (embolization)
• Radiation therapy
• Intralesional resection (S1–S5)
• En bloc resection (S1–S2)
• En bloc resection (S3–S5)

Malignant tumors (Chondrosarcoma, Osteosarcoma, Ewing's sarcoma, Chordoma)

C1–C7:

• Radiation therapy
• Neoadjuvant therapy
• En bloc resection of an anterior tumor (C1–C7)
• En bloc resection of a posterior tumor (C1–C7)
• Adjuvant therapy
• Palliative care

T1–T12:

• Radiation therapy
• Neoadjuvant therapy
• En bloc resection of an anterior tumor (T1–T12)
• En bloc resection of a posterior tumor (T1–T12)
• Adjuvant therapy
• Palliative care

L1–L5

• Radiation therapy
• Neoadjuvant therapy
• En bloc resection with posterior release and anterior tumor delivery (L1–L5)
• En bloc resection of a posterior tumor (L1–L5)
• Adjuvant therapy
• Palliative care

S1–S5

• Radiation therapy
• Neoadjuvant therapy
• En bloc resection (S1–S2)
• En bloc resection (S3–S5)
• Adjuvant therapy
• Palliative care

Approaches:

• Posterior access to the occipitocervical spine (C0–C2)
• Posterior access to the cervical spine (C3–C7)
• Anterior access to the cervical spine (C3–C7)
• Posterior access to the cervicothoracic junction (C7–T2)
• Posterior midline access to the thoracolumbar spine (T1–L5)
• Retroperitoneal approach (L4–S1)
• Posterior midline approach to the sacrum (S1–S5)

Patient preparations:

• Prone position for approaches to C0–C7
• Supine position for approaches to C3–C7
• Prone position for approaches to T1–S5
• Supine position for approaches to T1–S5

Further reading:

• Essential initial patient assessment
• Neurological examination
• Oncological and surgical staging
• Sagittal spinal alignment
• References on primary spine tumors

Basic techniques:

• Ligation of nerves
• Instrumentation for occipitocervical fixation
• Cervical discectomy
• PMMA application for vertebral body reconstruction
• Pedicle screw insertion (T1–T3)
• Pedicle screw insertion in the cervical spine
• Lateral mass screw insertion (Magerl technique)
• C1 lateral mass screw insertion
• C2 pedicle screw insertion
• C2 pars screw insertion
• C2 laminar screw insertion
• Pedicle screw insertion in the thoracolumbar spine
• S1 pedicle screw insertion
• Iliac screw insertion