En Bloc Spondylectomy
En Bloc Spondylectomy vs. Posterior Vertebral Column Resection
Definitions
En Bloc Spondylectomy (EBS): Surgical removal of an entire vertebral segment (vertebral body, pedicles, and posterior elements) in one piece. The primary goal is to achieve oncologic margins in spinal tumors.
Posterior Vertebral Column Resection (pVCR): Removal of one or more vertebral segments through a posterior-only approach, typically in a piecemeal fashion, to correct severe spinal deformities.
Comparison Table
| Feature | En Bloc Spondylectomy | Posterior Vertebral Column Resection |
|---|---|---|
| Main Goal | Oncologic resection with margins | Correction of severe deformity |
| Type of Resection | One-piece (en bloc) | Fragmented (piecemeal) |
| Indications | Primary or metastatic spinal tumors | Congenital kyphosis, post-traumatic deformity, scoliosis |
| Surgical Approach | Anterior, posterior, or combined (360º) | Posterior-only |
| Oncologic Application | Yes | No |
| Deformity Correction | Limited | Primary goal |
Key Differences
- EBS is aimed at curative treatment of vertebral tumors with wide margins.
- pVCR is used for severe, rigid spinal deformities requiring vertebral resection and spinal cord decompression.
- EBS often involves combined approaches, while pVCR is performed solely via a posterior approach.
Conclusion
Although both involve vertebral resection, they are not equivalent. Each serves a distinct purpose with different surgical techniques and goals.