{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:01:51Z","timestamp":1790139711484,"version":"4.0.1"},"reference-count":54,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Total en bloc spondylectomy (TES) of spinal tumors results in a large vertebral defect. Despite reconstruction and fusion, there is the potential concern for long-term mechanical stability. This retrospective cohort study investigated the long-term outcome of TES and reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Twenty-three patients (mean age 40.0 \u00b1 15.3 years) underwent TES for either primary spinal tumors or solitary metastasis and reconstruction with instrumented posterior spinal fusion and anterior fusion with titanium mesh cages at the authors' institution from November 2001 to April 2022. The mean follow-up was 11.5 \u00b1 4.9 years. Primary diagnoses included giant cell tumors (n = 13), primary sarcomas (n = 3), hemangiopericytomas (n = 2), solitary metastases (n = 2), aneurysmal bone cyst (n = 1), hemangioma (n = 1), and chordoma (n = 1). Tumors were located in the lumbar (n = 10) or thoracic (n = 13) spine. Fifteen patients had 1 vertebral level resected, 2 patients had 2, 4 patients had 3, 1 patient had 4, and 1 patient had 5 levels resected. The mean operative duration was 751.7 \u00b1 212.6 minutes, and the mean intraoperative blood loss was 2864.3 \u00b1 2124.8 ml. The mean length of resected tumor was 51.6 \u00b1 23.3 mm. Investigated outcomes were instrumentation failure, revision, and postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Twelve patients required revision surgery, 8 of whom had instrumentation failure with rod fracture. The mean time to instrumentation failure was 7.6 \u00b1 3.9 years. Instrumentation failure with rod fracture was associated with longer operation time (p = 0.031), more blood loss (p = 0.002), and a longer length of resected tumor (p = 0.035). No significant association was identified between instrumentation failure and radiological bony union, which was demonstrated in 73.9% of patients. The overall revision-free survivals were 67.0% and 48.8% at 5 and 10 years postoperatively, respectively. The 5- and 10-year instrumentation failure\u2013free survivals were 85.2% and 65.7%, respectively. Local recurrence of the pathology occurred in 3 patients (13.0%), with a mean time to local recurrence of 3.4 \u00b1 4.4 years. Kaplan-Meier analysis showed that 91.3% and 84.3% of the patients would be free from local recurrence at 5 and 10 years postoperatively, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Although local recurrence was uncommon after TES, revision surgery, particularly for instrumentation failure, emerged as a common late complication following TES. Long resection length and long complicated operations increase the likelihood of future instrumentation failure. Radiological bony union does not guarantee long-term success of the construct.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.3.spine241451","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T21:16:52Z","timestamp":1750454212000},"page":"265-272","source":"Crossref","is-referenced-by-count":5,"title":["Outcomes after total en bloc spondylectomy at a mean follow-up of 11 years"],"prefix":"10.3171","volume":"43","author":[{"given":"Wai Kiu Thomas","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yat Wa","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, University of Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenny Yat Hong","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, University of Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Paraplegia","first-page":"36","article-title":"Total en bloc spondylectomy and circumspinal decompression for solitary spinal metastasis","volume":"32","author":"Tomita K","year":"1994","unstructured":"Tomita K, Toribatake Y, Kawahara N, Ohnari H, Kose H. Total en bloc spondylectomy and circumspinal decompression for solitary spinal metastasis. Paraplegia. 1994;32(1):36\u201346."},{"issue":"4","key":"b2","series-title":"Ann Surg Oncol","first-page":"1330","article-title":"More than 10-year follow-up after total en bloc spondylectomy for spinal tumors","volume":"21","author":"Kato S","year":"2014","unstructured":"Kato S, Murakami H, Demura S,  More than 10-year follow-up after total en bloc spondylectomy for spinal tumors. Ann Surg Oncol. 2014;21(4):1330\u20131336."},{"key":"b3","series-title":"World Neurosurg","first-page":"e106","article-title":"Risk factors for instrumentation failure after total en bloc spondylectomy of thoracic and lumbar spine tumors using titanium mesh cage for anterior reconstruction","volume":"135","author":"Li Z","year":"2020","unstructured":"Li Z, Wei F, Liu Z,  Risk factors for instrumentation failure after total en bloc spondylectomy of thoracic and lumbar spine tumors using titanium mesh cage for anterior reconstruction. World Neurosurg. 2020;135:e106\u2013e115."},{"issue":"3","key":"b4","series-title":"J Neurosurg Spine","first-page":"320","article-title":"Late instrumentation failure after total en bloc spondylectomy","volume":"15","author":"Matsumoto M","year":"2011","unstructured":"Matsumoto M, Watanabe K, Tsuji T,  Late instrumentation failure after total en bloc spondylectomy. J Neurosurg Spine. 2011;15(3):320\u2013327."},{"issue":"10","key":"b5","series-title":"Spine J","first-page":"1613","article-title":"Rod fracture and related factors after total en bloc spondylectomy","volume":"19","author":"Park SJ","year":"2019","unstructured":"Park SJ, Lee CS, Chang BS,  Rod fracture and related factors after total en bloc spondylectomy. Spine J. 2019;19(10):1613\u20131619."},{"issue":"12","key":"b6","series-title":"Eur Spine J","first-page":"4080","article-title":"Total en bloc spondylectomy for locally aggressive and primary malignant tumors of the lumbar spine","volume":"25","author":"Sciubba DM","year":"2016","unstructured":"Sciubba DM, De la Garza Ramos R, Goodwin CR,  Total en bloc spondylectomy for locally aggressive and primary malignant tumors of the lumbar spine. Eur Spine J. 2016;25(12):4080\u20134087."},{"issue":"17","key":"b7","series-title":"J Bone Joint Surg Am","first-page":"1476","article-title":"Modified en bloc spondylectomy for tumors of the thoracic and lumbar spine: surgical technique and outcomes","volume":"99","author":"Shah AA","year":"2017","unstructured":"Shah AA, Paulino Pereira NR, Pedlow FX,  Modified en bloc spondylectomy for tumors of the thoracic and lumbar spine: surgical technique and outcomes. J Bone Joint Surg Am. 2017;99(17):1476\u20131484."},{"issue":"37","key":"b8","series-title":"Medicine (Baltimore)","first-page":"e12366","article-title":"Total en bloc spondylectomy for primary tumors of the lumbar spine","volume":"97","author":"Shimizu T","year":"2018","unstructured":"Shimizu T, Murakami H, Demura S,  Total en bloc spondylectomy for primary tumors of the lumbar spine. Medicine (Baltimore). 2018;97(37):e12366."},{"issue":"2","key":"b9","series-title":"Bone Joint J","first-page":"172","article-title":"Characteristics and risk factors of instrumentation failure following total en bloc spondylectomy","volume":"105-B","author":"Shimizu T","year":"2023","unstructured":"Shimizu T, Kato S, Demura S,  Characteristics and risk factors of instrumentation failure following total en bloc spondylectomy. Bone Joint J. 2023;105-B(2):172-179."},{"issue":"5","key":"b10","series-title":"Bone Joint J","first-page":"976","article-title":"Perioperative complications of total en bloc spondylectomy for spinal tumours","volume":"103-B","author":"Demura S","year":"2021","unstructured":"Demura S, Kato S, Shinmura K,  Perioperative complications of total en bloc spondylectomy for spinal tumours. Bone Joint J. 2021;103-B(5):976-983."},{"issue":"1","key":"b11","series-title":"Spine Surg Relat Res","first-page":"31","article-title":"Risk factors of instrumentation failure after multilevel total en bloc spondylectomy","volume":"1","author":"Yoshioka K","year":"2017","unstructured":"Yoshioka K, Murakami H, Demura S,  Risk factors of instrumentation failure after multilevel total en bloc spondylectomy. Spine Surg Relat Res. 2017;1(1):31\u201339."},{"issue":"1","key":"b12","series-title":"J Orthop Sci","first-page":"3","article-title":"Total en bloc spondylectomy for spinal tumors: improvement of the technique and its associated basic background","volume":"11","author":"Tomita K","year":"2006","unstructured":"Tomita K, Kawahara N, Murakami H, Demura S. Total en bloc spondylectomy for spinal tumors: improvement of the technique and its associated basic background. J Orthop Sci. 2006;11(1):3\u201312."},{"issue":"1","key":"b13","series-title":"Neurospine","first-page":"146","article-title":"Mechanical failure after total en bloc spondylectomy and salvage surgery","volume":"19","author":"Kwon SW","year":"2022","unstructured":"Kwon SW, Chung CK, Won YI,  Mechanical failure after total en bloc spondylectomy and salvage surgery. Neurospine. 2022;19(1):146\u2013154."},{"issue":"1","key":"b14","series-title":"BMC Musculoskelet Disord","first-page":"591","article-title":"Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series","volume":"21","author":"Shinmura K","year":"2020","unstructured":"Shinmura K, Kato S, Demura S,  Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series. BMC Musculoskelet Disord. 2020;21(1):591."},{"issue":"3","key":"b15","series-title":"Clin Orthop Relat Res","first-page":"858","article-title":"Multilevel en bloc spondylectomy for tumors of the thoracic and lumbar spine is challenging but rewarding","volume":"473","author":"Luzzati AD","year":"2015","unstructured":"Luzzati AD, Shah S, Gagliano F, Perrucchini G, Scotto G, Alloisio M. Multilevel en bloc spondylectomy for tumors of the thoracic and lumbar spine is challenging but rewarding. Clin Orthop Relat Res. 2015;473(3):858\u2013867."},{"issue":"11","key":"b16","series-title":"Orthopedics","first-page":"e995","article-title":"Total en bloc spondylectomy for primary and metastatic spine tumors","volume":"38","author":"Mesfin A","year":"2015","unstructured":"Mesfin A, El Dafrawy MH, Jain A, Hassanzadeh H, Kebaish KM. Total en bloc spondylectomy for primary and metastatic spine tumors. Orthopedics. 2015;38(11):e995\u2013e1000."},{"issue":"24","key":"b17","series-title":"Spine (Phila Pa 1976).","first-page":"E1511","article-title":"Clinical outcome of spinal reconstruction after total en bloc spondylectomy at 3 or more levels","volume":"38","author":"Yoshioka K","year":"2013","unstructured":"Yoshioka K, Murakami H, Demura S,  Clinical outcome of spinal reconstruction after total en bloc spondylectomy at 3 or more levels. Spine (Phila Pa 1976).2013;38(24):E1511\u2013E1516."},{"issue":"2","key":"b18","series-title":"Neurosurgery","first-page":"435","article-title":"En bloc resection for primary and metastatic tumors of the spine: a systematic review of the literature","volume":"67","author":"Cloyd JM","year":"2010","unstructured":"Cloyd JM, Acosta FL, Jr., Polley MY, Ames CP. En bloc resection for primary and metastatic tumors of the spine: a systematic review of the literature. Neurosurgery. 2010;67(2):435\u2013445."},{"issue":"12","key":"b19","series-title":"Bone Joint J","first-page":"1693","article-title":"Patient-reported outcome and quality of life after total en bloc spondylectomy for a primary spinal tumour","volume":"96-B","author":"Kato S","year":"2014","unstructured":"Kato S, Murakami H, Demura S,  Patient-reported outcome and quality of life after total en bloc spondylectomy for a primary spinal tumour. Bone Joint J. 2014;96-B(12):1693-1698."},{"issue":"11","key":"b20","series-title":"Spine J","first-page":"2608","article-title":"En bloc resections for primary spinal tumors in 20 years of experience: effectiveness and safety","volume":"14","author":"Amendola L","year":"2014","unstructured":"Amendola L, Cappuccio M, De Iure F, Bandiera S, Gasbarrini A, Boriani S. En bloc resections for primary spinal tumors in 20 years of experience: effectiveness and safety. Spine J. 2014;14(11):2608\u20132617."},{"issue":"8","key":"b21","series-title":"Eur Spine J","first-page":"1747","article-title":"Treatment and outcome of primary aggressive giant cell tumor in the spine","volume":"24","author":"Yin H","year":"2015","unstructured":"Yin H, Yang X, Xu W,  Treatment and outcome of primary aggressive giant cell tumor in the spine. Eur Spine J. 2015;24(8):1747\u20131753."},{"issue":"2","key":"b22","series-title":"Eur Spine J","first-page":"231","article-title":"Morbidity of en bloc resections in the spine","volume":"19","author":"Boriani S","year":"2010","unstructured":"Boriani S, Bandiera S, Donthineni R,  Morbidity of en bloc resections in the spine. Eur Spine J. 2010;19(2):231\u2013241."},{"issue":"1","key":"b23","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Bone graft options for spinal fusion following resection of spinal column tumors: systematic review and meta-analysis","volume":"42","author":"Elder BD","year":"2017","unstructured":"Elder BD, Ishida W, Goodwin CR,  Bone graft options for spinal fusion following resection of spinal column tumors: systematic review and meta-analysis. Neurosurg Focus. 2017;42(1):E16."},{"issue":"1","key":"b24","series-title":"BMC Musculoskelet Disord","first-page":"364","article-title":"Perioperative complications of en bloc resection and anterior column reconstruction for thoracic and lumbar spinal tumors","volume":"25","author":"Tang Y","year":"2024","unstructured":"Tang Y, Li H, Liu S,  Perioperative complications of en bloc resection and anterior column reconstruction for thoracic and lumbar spinal tumors. BMC Musculoskelet Disord. 2024;25(1):364."},{"issue":"24","key":"b25","series-title":"Spine (Phila Pa 1976).","first-page":"2783","article-title":"The transmission of stress to grafted bone inside a titanium mesh cage used in anterior column reconstruction after total spondylectomy: a finite-element analysis","volume":"30","author":"Akamaru T","year":"2005","unstructured":"Akamaru T, Kawahara N, Sakamoto J,  The transmission of stress to grafted bone inside a titanium mesh cage used in anterior column reconstruction after total spondylectomy: a finite-element analysis. Spine (Phila Pa 1976).2005;30(24):2783\u20132787."},{"issue":"3","key":"b26","series-title":"Int Orthop","first-page":"469","article-title":"New posterior column reconstruction using titanium lamina mesh after total en bloc spondylectomy of spinal tumour","volume":"37","author":"Chung JY","year":"2013","unstructured":"Chung JY, Kim SK, Jung ST, Lee KB. New posterior column reconstruction using titanium lamina mesh after total en bloc spondylectomy of spinal tumour. Int Orthop. 2013;37(3):469\u2013476."},{"key":"b27","series-title":"World Neurosurg","first-page":"e530","article-title":"Rod fracture after apparently solid radiographic fusion in adult spinal deformity patients","volume":"117","author":"Daniels AH","year":"2018","unstructured":"Daniels AH, DePasse JM, Durand W,  Rod fracture after apparently solid radiographic fusion in adult spinal deformity patients. World Neurosurg. 2018;117:e530\u2013e537."},{"issue":"1","key":"b1","series-title":"Paraplegia","first-page":"36","article-title":"Total en bloc spondylectomy and circumspinal decompression for solitary spinal metastasis","volume":"32","author":"Tomita K","year":"1994","unstructured":"Tomita K, Toribatake Y, Kawahara N, Ohnari H, Kose H. Total en bloc spondylectomy and circumspinal decompression for solitary spinal metastasis. Paraplegia. 1994;32(1):36\u201346."},{"issue":"4","key":"b2","series-title":"Ann Surg Oncol","first-page":"1330","article-title":"More than 10-year follow-up after total en bloc spondylectomy for spinal tumors","volume":"21","author":"Kato S","year":"2014","unstructured":"Kato S, Murakami H, Demura S,  More than 10-year follow-up after total en bloc spondylectomy for spinal tumors. Ann Surg Oncol. 2014;21(4):1330\u20131336."},{"key":"b3","series-title":"World Neurosurg","first-page":"e106","article-title":"Risk factors for instrumentation failure after total en bloc spondylectomy of thoracic and lumbar spine tumors using titanium mesh cage for anterior reconstruction","volume":"135","author":"Li Z","year":"2020","unstructured":"Li Z, Wei F, Liu Z,  Risk factors for instrumentation failure after total en bloc spondylectomy of thoracic and lumbar spine tumors using titanium mesh cage for anterior reconstruction. World Neurosurg. 2020;135:e106\u2013e115."},{"issue":"3","key":"b4","series-title":"J Neurosurg Spine","first-page":"320","article-title":"Late instrumentation failure after total en bloc spondylectomy","volume":"15","author":"Matsumoto M","year":"2011","unstructured":"Matsumoto M, Watanabe K, Tsuji T,  Late instrumentation failure after total en bloc spondylectomy. J Neurosurg Spine. 2011;15(3):320\u2013327."},{"issue":"10","key":"b5","series-title":"Spine J","first-page":"1613","article-title":"Rod fracture and related factors after total en bloc spondylectomy","volume":"19","author":"Park SJ","year":"2019","unstructured":"Park SJ, Lee CS, Chang BS,  Rod fracture and related factors after total en bloc spondylectomy. Spine J. 2019;19(10):1613\u20131619."},{"issue":"12","key":"b6","series-title":"Eur Spine J","first-page":"4080","article-title":"Total en bloc spondylectomy for locally aggressive and primary malignant tumors of the lumbar spine","volume":"25","author":"Sciubba DM","year":"2016","unstructured":"Sciubba DM, De la Garza Ramos R, Goodwin CR,  Total en bloc spondylectomy for locally aggressive and primary malignant tumors of the lumbar spine. Eur Spine J. 2016;25(12):4080\u20134087."},{"issue":"17","key":"b7","series-title":"J Bone Joint Surg Am","first-page":"1476","article-title":"Modified en bloc spondylectomy for tumors of the thoracic and lumbar spine: surgical technique and outcomes","volume":"99","author":"Shah AA","year":"2017","unstructured":"Shah AA, Paulino Pereira NR, Pedlow FX,  Modified en bloc spondylectomy for tumors of the thoracic and lumbar spine: surgical technique and outcomes. J Bone Joint Surg Am. 2017;99(17):1476\u20131484."},{"issue":"37","key":"b8","series-title":"Medicine (Baltimore)","first-page":"e12366","article-title":"Total en bloc spondylectomy for primary tumors of the lumbar spine","volume":"97","author":"Shimizu T","year":"2018","unstructured":"Shimizu T, Murakami H, Demura S,  Total en bloc spondylectomy for primary tumors of the lumbar spine. Medicine (Baltimore). 2018;97(37):e12366."},{"issue":"2","key":"b9","series-title":"Bone Joint J","first-page":"172","article-title":"Characteristics and risk factors of instrumentation failure following total en bloc spondylectomy","volume":"105-B","author":"Shimizu T","year":"2023","unstructured":"Shimizu T, Kato S, Demura S,  Characteristics and risk factors of instrumentation failure following total en bloc spondylectomy. Bone Joint J. 2023;105-B(2):172-179."},{"issue":"5","key":"b10","series-title":"Bone Joint J","first-page":"976","article-title":"Perioperative complications of total en bloc spondylectomy for spinal tumours","volume":"103-B","author":"Demura S","year":"2021","unstructured":"Demura S, Kato S, Shinmura K,  Perioperative complications of total en bloc spondylectomy for spinal tumours. Bone Joint J. 2021;103-B(5):976-983."},{"issue":"1","key":"b11","series-title":"Spine Surg Relat Res","first-page":"31","article-title":"Risk factors of instrumentation failure after multilevel total en bloc spondylectomy","volume":"1","author":"Yoshioka K","year":"2017","unstructured":"Yoshioka K, Murakami H, Demura S,  Risk factors of instrumentation failure after multilevel total en bloc spondylectomy. Spine Surg Relat Res. 2017;1(1):31\u201339."},{"issue":"1","key":"b12","series-title":"J Orthop Sci","first-page":"3","article-title":"Total en bloc spondylectomy for spinal tumors: improvement of the technique and its associated basic background","volume":"11","author":"Tomita K","year":"2006","unstructured":"Tomita K, Kawahara N, Murakami H, Demura S. Total en bloc spondylectomy for spinal tumors: improvement of the technique and its associated basic background. J Orthop Sci. 2006;11(1):3\u201312."},{"issue":"1","key":"b13","series-title":"Neurospine","first-page":"146","article-title":"Mechanical failure after total en bloc spondylectomy and salvage surgery","volume":"19","author":"Kwon SW","year":"2022","unstructured":"Kwon SW, Chung CK, Won YI,  Mechanical failure after total en bloc spondylectomy and salvage surgery. Neurospine. 2022;19(1):146\u2013154."},{"issue":"1","key":"b14","series-title":"BMC Musculoskelet Disord","first-page":"591","article-title":"Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series","volume":"21","author":"Shinmura K","year":"2020","unstructured":"Shinmura K, Kato S, Demura S,  Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series. BMC Musculoskelet Disord. 2020;21(1):591."},{"issue":"3","key":"b15","series-title":"Clin Orthop Relat Res","first-page":"858","article-title":"Multilevel en bloc spondylectomy for tumors of the thoracic and lumbar spine is challenging but rewarding","volume":"473","author":"Luzzati AD","year":"2015","unstructured":"Luzzati AD, Shah S, Gagliano F, Perrucchini G, Scotto G, Alloisio M. Multilevel en bloc spondylectomy for tumors of the thoracic and lumbar spine is challenging but rewarding. Clin Orthop Relat Res. 2015;473(3):858\u2013867."},{"issue":"11","key":"b16","series-title":"Orthopedics","first-page":"e995","article-title":"Total en bloc spondylectomy for primary and metastatic spine tumors","volume":"38","author":"Mesfin A","year":"2015","unstructured":"Mesfin A, El Dafrawy MH, Jain A, Hassanzadeh H, Kebaish KM. Total en bloc spondylectomy for primary and metastatic spine tumors. Orthopedics. 2015;38(11):e995\u2013e1000."},{"issue":"24","key":"b17","series-title":"Spine (Phila Pa 1976).","first-page":"E1511","article-title":"Clinical outcome of spinal reconstruction after total en bloc spondylectomy at 3 or more levels","volume":"38","author":"Yoshioka K","year":"2013","unstructured":"Yoshioka K, Murakami H, Demura S,  Clinical outcome of spinal reconstruction after total en bloc spondylectomy at 3 or more levels. Spine (Phila Pa 1976).2013;38(24):E1511\u2013E1516."},{"issue":"2","key":"b18","series-title":"Neurosurgery","first-page":"435","article-title":"En bloc resection for primary and metastatic tumors of the spine: a systematic review of the literature","volume":"67","author":"Cloyd JM","year":"2010","unstructured":"Cloyd JM, Acosta FL, Jr., Polley MY, Ames CP. En bloc resection for primary and metastatic tumors of the spine: a systematic review of the literature. Neurosurgery. 2010;67(2):435\u2013445."},{"issue":"12","key":"b19","series-title":"Bone Joint J","first-page":"1693","article-title":"Patient-reported outcome and quality of life after total en bloc spondylectomy for a primary spinal tumour","volume":"96-B","author":"Kato S","year":"2014","unstructured":"Kato S, Murakami H, Demura S,  Patient-reported outcome and quality of life after total en bloc spondylectomy for a primary spinal tumour. Bone Joint J. 2014;96-B(12):1693-1698."},{"issue":"11","key":"b20","series-title":"Spine J","first-page":"2608","article-title":"En bloc resections for primary spinal tumors in 20 years of experience: effectiveness and safety","volume":"14","author":"Amendola L","year":"2014","unstructured":"Amendola L, Cappuccio M, De Iure F, Bandiera S, Gasbarrini A, Boriani S. En bloc resections for primary spinal tumors in 20 years of experience: effectiveness and safety. Spine J. 2014;14(11):2608\u20132617."},{"issue":"8","key":"b21","series-title":"Eur Spine J","first-page":"1747","article-title":"Treatment and outcome of primary aggressive giant cell tumor in the spine","volume":"24","author":"Yin H","year":"2015","unstructured":"Yin H, Yang X, Xu W,  Treatment and outcome of primary aggressive giant cell tumor in the spine. Eur Spine J. 2015;24(8):1747\u20131753."},{"issue":"2","key":"b22","series-title":"Eur Spine J","first-page":"231","article-title":"Morbidity of en bloc resections in the spine","volume":"19","author":"Boriani S","year":"2010","unstructured":"Boriani S, Bandiera S, Donthineni R,  Morbidity of en bloc resections in the spine. Eur Spine J. 2010;19(2):231\u2013241."},{"issue":"1","key":"b23","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Bone graft options for spinal fusion following resection of spinal column tumors: systematic review and meta-analysis","volume":"42","author":"Elder BD","year":"2017","unstructured":"Elder BD, Ishida W, Goodwin CR,  Bone graft options for spinal fusion following resection of spinal column tumors: systematic review and meta-analysis. Neurosurg Focus. 2017;42(1):E16."},{"issue":"1","key":"b24","series-title":"BMC Musculoskelet Disord","first-page":"364","article-title":"Perioperative complications of en bloc resection and anterior column reconstruction for thoracic and lumbar spinal tumors","volume":"25","author":"Tang Y","year":"2024","unstructured":"Tang Y, Li H, Liu S,  Perioperative complications of en bloc resection and anterior column reconstruction for thoracic and lumbar spinal tumors. BMC Musculoskelet Disord. 2024;25(1):364."},{"issue":"24","key":"b25","series-title":"Spine (Phila Pa 1976).","first-page":"2783","article-title":"The transmission of stress to grafted bone inside a titanium mesh cage used in anterior column reconstruction after total spondylectomy: a finite-element analysis","volume":"30","author":"Akamaru T","year":"2005","unstructured":"Akamaru T, Kawahara N, Sakamoto J,  The transmission of stress to grafted bone inside a titanium mesh cage used in anterior column reconstruction after total spondylectomy: a finite-element analysis. Spine (Phila Pa 1976).2005;30(24):2783\u20132787."},{"issue":"3","key":"b26","series-title":"Int Orthop","first-page":"469","article-title":"New posterior column reconstruction using titanium lamina mesh after total en bloc spondylectomy of spinal tumour","volume":"37","author":"Chung JY","year":"2013","unstructured":"Chung JY, Kim SK, Jung ST, Lee KB. New posterior column reconstruction using titanium lamina mesh after total en bloc spondylectomy of spinal tumour. Int Orthop. 2013;37(3):469\u2013476."},{"key":"b27","series-title":"World Neurosurg","first-page":"e530","article-title":"Rod fracture after apparently solid radiographic fusion in adult spinal deformity patients","volume":"117","author":"Daniels AH","year":"2018","unstructured":"Daniels AH, DePasse JM, Durand W,  Rod fracture after apparently solid radiographic fusion in adult spinal deformity patients. 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