Total en bloc spondylectomy of the eleventh thoracic vertebra following denosumab therapy for the treatment of a giant cell tumor

摘要

Although denosumab has been reported to induce effective clinical results with respect to tumor shrinkage in a short-term follow-up clinical study, total spondylectomy is recognized as the treatment of choice for eradicating giant cell tumors (GCTs) of the spine. The present study reports the case involving a GCT in the 11th thoracic vertebra complicated by idiopathic scoliosis and treated using total en bloc spondylectomy (TES) with preoperative denosumab therapy. A 35-year-old woman received preoperative denosumab therapy for 8 months, followed by surgery using a computed tomography (CT)-based navigation system that optimized accuracy by recognizing the area of the detached parietal pleura, the irregular border of the collapsed vertebra, and the adjacent vertebra. Complete en bloc resection of the vertebra could be performed, suggesting denosumab can be an effective adjuvant therapy which can reduce the complexity of TES and CT-navigation system facilitated the safe use of this surgical method in a patient with idiopathic scoliosis.