Radiofrequency ablation in gross total excision of cervical chordoma: ideas and technique.

PURPOSE: To use radiofrequency ablation (RFA) in the resection of C4 cervical chordoma with a giant paravertebral tumor mass to achieve tumor-free exposed margins and perform a gross total excision.

METHODS: A gross total excision using combined posterior and anterior approaches was performed. In the posterior stage, the C4 posterior arch was removed and the C4/C5 nerve roots and vertebral artery were released from the tumor. In the anterior stage, the giant soft mass of tumor from C3 to C6 was treated with RFA to make it shrink and solidify visually to achieve tumor-free exposed margins before resecting the tumor. Finally, a gross total excision was performed followed by the implantation of titanium plate and mesh filled with allograft bone.

RESULTS: A gross total excision was performed with tumor-free exposed margins and radiotherapy. The patient survived more than 5 years without recurrence.

CONCLUSIONS: RFA can help achieve tumor-free exposed margins. A gross total excision combined with RFA can improve the local relapse-free survival of patients with cervical chordoma. These slides can be retrieved under Electronic Supplementary Material.