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Because of the special anatomy of the lumbosacral junction, TES procedure at the L5 level is a challenge, and it has been explained in few reports in the literature. Performing TES in the lower lumbar region, as normal, is accomplished by using a combined approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors presented the case of a 20-year-old man with an isolated spinal metastasis at the L5 level of carcinoid tumor of jejunum, limited to the vertebral body. Due to good long-term prognosis, after multidisciplinary evaluation the authors decided to treat the patient with TES through a combined posteroanterior approach, with posterior instrumentation and anterior reconstruction. Nine years after surgery, the patient was asymptomatic, with no sign of local recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>TES is a feasible technique to provide long-term survival in a select subgroup of patients, reducing the risk of local recurrence. The authors presented some anatomical and biomechanical factors that must be considered at the lumbosacral region. Despite the high rates of complication associated with TES, most patients benefit from local control provided by the technique.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case21666","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T04:06:41Z","timestamp":1660536401000},"source":"Crossref","is-referenced-by-count":4,"title":["Total en bloc spondylectomy for the L5 metastasis of a carcinoid tumor: illustrative case"],"prefix":"10.3171","volume":"4","author":[{"given":"Cristina P.","family":"J\u00f3dar","sequence":"first","affiliation":[{"name":"Departments of Orthopedic Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sim\u00f3n","family":"Fuentes Caparr\u00f3s","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel A.","family":"Mar\u00edn","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Osuna Soto","sequence":"additional","affiliation":[{"name":"Pathological Anatomy, Hospital Universitario Reina Sof\u00eda, C\u00f3rdoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Orthop Clin North Am","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/S0030-5898(05)70171-1","article-title":"Incidence, location, and diagnostic evaluation of metastatic bone disease","volume":"31","author":"Hage WD","year":"2000","unstructured":"Hage WD, Aboulafia AJ, Aboulafia DM. 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