Use of patient-specific 3D reconstruction models for en bloc resection of primary thoracic vertebral sarcomas without formal spondylectomy: illustrative cases.

BACKGROUND

En bloc resection remains the treatment of choice for primary vertebral column sarcomas but often necessitates total spondylectomy, a procedure associated with high morbidity. The use of patient-specific 3D reconstruction models in combination with intraoperative neuronavigation provides a strategy to achieve oncological resection goals while minimizing resection of uninvolved bone and reducing complication rates.

OBSERVATIONS: The authors present 2 cases of thoracic vertebral sarcomas successfully resected en bloc using patient-specific 3D models and intraoperative neuronavigation without performing formal spondylectomy. Postoperative imaging confirmed gross-total resection, and both patients showed durable symptom relief with no evidence of recurrence on follow-up.

LESSONS: Integrating 3D modeling and neuronavigation enables tailored en bloc resections of thoracic vertebral sarcomas. This approach preserves structural stability and avoids spondylectomy in select cases, supporting improved oncological and functional outcomes. https://thejns.org/doi/10.3171/CASE25672.