Surgical treatment of lumbar chordoma

Keywords: chordoma; sacrum; tumor; surgical treatment; radiotherapy


Objective. Аnalysis of surgical procedure, results of surgical and combined treatment of lumbar chordoma.

Маterials and methods. In 28 patients, suffering lumbar chordoma, the disease symptoms and their dynamics, value of the neurovisualization method, peculiarities of pathohistological picture, surgical procedure, еfficacy of radiation therapy and late results of treatment were analyzed.

Results. Among clinical signs of lumbar chordoma the pain syndrome have dominated. Median duration of anamnesis have constituted approximately one year. Surgical resection of the tumor via posterior approach was done in 18 patients, and via a combined one – in 9 patients. Excision of the tumors was estimated as a radical in 21 patients, and as a partial one – in 7 patients. Postoperatively in all the patients a course of radiation therapy, using linear accelerators, was conducted. Through five years of follow–up in 26 patients recurrence of chordoma have occurred. Reoperations were performed in 22 patients.

Conclusion. Treatment of chordomas needs complex approach. Conduction of radical surgical intervention, what is not possible in all the patients, still constitutes the method of choice.

Author Biographies

M. M. Leshko, Оlexandrivskyi Clinical Hospital, Kyiv

Mikhail М. Leshko M.D, Ph.D.
Department of Neurosurgery
Alexander clinical hospital,
39/1 Shovkovichna St, Kyiv, Ukraine, 01601

E. I. Slynko, Romodanov Іnstitute of Neurosurgery, Kyiv

Evgeni І. Slynko MD, PhD Professor
Head of Spinal Department
Romodanov Neurosurgery Institute,
32 Platona Mayborody St, Kyiv, Ukraine, 04050

T. A. Malysheva, Romodanov Іnstitute of Neurosurgery, Kyiv

Tatiana A. Malysheva MD, PhD Professor
Head of Neuropathomorphology Department
Romodanov Neurosurgery Institute,
32 Platona Mayborody St, Kyiv, Ukraine, 04050


1. Konakondla S, Albers JA, Li X, Barber SM, Nakhla J, Houghton CE, et al. Maximizing Sacral Chordoma Resection by Precise 3-D Tumor Modeling in the OR using Intra-Operative CT Registration with Pre-Operative MRI Fusion and Intra-Operative Neuronavigation: A Case Series. World Neurosurg. 2019 Feb 18. pii: S1878-8750(19)30376-6.
2. Houdek MT, Rose PS, Hevesi M, Schwab JH, Griffin AM, Healey JH, et al. Low dose radiotherapy is associated with local complications but not disease control in sacral chordoma. J Surg Oncol. 2019 Feb 7.
3. Kashlan ON, Monson DK, Refai D. The Use of Anterior Lumbosacral Interbody Fusion in Spinopelvic Stabilization After High Partial Sacrectomy. Oper Neurosurg (Hagerstown). 2019 Jan 9.
4. Yang Y, Li Y, Liu W, Xu H, Niu X. The clinical outcome of recurrent sacral chordoma with further surgical treatment. Medicine (Baltimore). 2018 Dec;97(52):e13730. doi:
5. Zuckerman SL, Amini B, Lee SH, Rao G, Tatsui CE, Rhines LD. Predictive Value of Preoperative Magnetic Resonance Imaging Findings for Survival and Local Recurrence in Patients Undergoing En Bloc Resection of Sacral Chordomas. Neurosurgery. 2018 Dec 12.
6. Dea N, Fisher CG, Reynolds JJ, Schwab JH, Rhines LD, Gokaslan ZL, et al. Current treatment strategy for newly diagnosed chordoma of the mobile spine and sacrum: results of an international survey. J Neurosurg Spine. 2019 Jan;30(1):119-25.
7. van Wulfften Palthe ODR, Tromp I, Ferreira A, Fiore A, Bramer JAM, van Dijk NC, et al. Sacral chordoma: a clinical review of 101 cases with 30-year experience in a single institution. Spine J. 2018 Nov 14.
8. Liang WS, Dardis C, Helland A, Sekar S, Adkins J, Cuyugan L, et al. Identification of therapeutic targets in chordoma through comprehensive genomic and transcriptomic analyses. Cold Spring Harb Mol Case Stud. 2018 Dec;4(6):a003418.
How to Cite
Leshko, M. M., Slynko, E. I., & Malysheva, T. A. (2019). Surgical treatment of lumbar chordoma. Klinicheskaia Khirurgiia, 86(3), 56-59.
General Problems of Surgery