Follow-up evaluation of resected lumbar vertebral chordoma over 11 years -A case report

Study Design. A case report with an Ii-year follow-up assessment after rese ction end reconstruction for lumbar chordoma is given. The literature relev ant to this topic is reviewed. Objectives. To report the long-term outcome in a case of lumbar chordoma, t o review the literature on vertebral chordoma, and to outline the rationale for surgical resection in such cases. Summary of Background Data. Chordoma is a malignant bone tumor that grows s lowly, often recurs locally, and metastasizes late. Although different trea tment approaches exist, including radiation and surgery, the only curative treatment is early and complete surgical excision of the tumor. Immediate s pinal stability must be achieved with appropriate replacement or bone graft with rigid fixation. Methods. The 11-year follow-up evaluation of a 42-year-old woman with L3 an d L4 vertebral body chordoma treated with complete removal, femoral shaft a llograft replacement, fusion, and rigid metal fixation is reported. The pat ient was observed with serial physical examinations, radiographs, and labor atory studies over 11 years. Results. At this writing, 11 years after the resection of the L3 and L4 cho rdoma, the patient is asymptomatic without evidence of recurrence or metast asis. Conclusions. As reported, vertebral chordomas are not curable, but the auth ors' experience contradicts this. The surgeon should aim at a wide, or at l east a marginal, excision followed by a stable reconstruction.