<i>En bloc</i> resection of the posterior musculature and spinal column for a malignant dorsal tumor: A technical report

Background: En bloc resection of extensive dorsal tumors with simultaneous spinal reconstruction is technically demanding. Achieving adequate margins while preserving structural stability presents a significant surgical challenge. Methods: We treated an Ewing sarcoma family tumor extensively infiltrating the posterior spinal elements and bilateral paraspinal soft tissues. Using a bilateral soft-tissue elevation approach, osteotomies were performed under navigation guidance, allowing safe en bloc resection of the tumor together with involved posterior spinal structures. Following preoperative and postoperative chemotherapy and radiotherapy, anterior spinal reconstruction was subsequently performed. Results: At one year follow-up, the patient demonstrated stable spinal alignment with no evidence of local recurrence. Conclusion: This report describes a feasible surgical strategy for achieving en bloc resection of large posterior trunk tumors with spinal involvement, using navigation-assisted osteotomies and staged reconstruction.