{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T04:08:29Z","timestamp":1744430909641,"version":"3.40.4"},"reference-count":54,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background<\/jats:title>\n<jats:p>Mobile spine chordomas demonstrate varied surgical risk profiles compared to their sacral analogs. Often, the limitation to performing an <jats:italic>en bloc<\/jats:italic> resection of a mobile spine chordoma is tumor violation of the epidural space. Given these limitations, we propose the utilization of carbon fiber-reinforced polyetheretherketone (CFR-PEEK) instrumentation in separation surgery to enhance visualization for stereotactic body radiation therapy (SBRT) planning, allowing an ablative radiosurgical dose to be delivered.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We present two illustrative cases highlighting the advantages of hybrid therapy (separation surgery and adjuvant SBRT) with CFR-PEEK instrumentation in the management of mobile spine chordoma.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results<\/jats:title>\n<jats:p>Case 1 is a 62-year-old female with an L4 chordoma who underwent separation surgery and L3\u20135 posterior instrumented fusion using CFR-PEEK instrumentation. Case 2 is a 68-year-old female with a L3 chordoma who underwent revision separation surgery encompassing completion of L3 partial corpectomy and CFR-PEEK screw exchange of prior L2\u20134 titanium instrumentation. Both patients received postoperative ablative SBRT. At 18-month postoperative time points, both patients were clinically stable, with no signs of tumor recurrence or progression.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Mobile spine chordomas present a unique challenge in obtaining a margin negative <jats:italic>en bloc<\/jats:italic> resection. Separation surgery allows the ability to decrease surgical morbidity and deliver an ablative radiosurgical dose. Furthermore, the incorporation of CFR-PEEK instrumentation allows the utilization of multiparametric magnetic resonance imaging for long-term disease monitoring. Hybrid therapy, a less morbid alternative to standard <jats:italic>en bloc<\/jats:italic> spondylectomy, offers a better surgical morbidity profile by combining effectively with SBRT for optimal tumor control.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_53_2025","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T10:35:20Z","timestamp":1744367720000},"page":"130","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid therapy and use of carbon-fiber-reinforced polyetheretherketone instrumentation for management of mobile spine chordomas: A case series and review of the literature"],"prefix":"10.25259","volume":"16","author":[{"given":"Chi Shing Adrian","family":"Lam","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University Wexner Medical Center, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicente de Paulo","family":"Martins Coelho","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University Wexner Medical Center, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University Wexner Medical Center, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anas","family":"Bardeesi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University Wexner Medical Center, United 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