• Yoichi Shimada, Michio Hongo, Naohisa Miyakoshi, Yuji Kasukawa, Shigeru Ando, Eiji Itoi, and Eiji Abe.
• Rehabilitation Division and Spine Division, Akita University Hospital, 1-1-1 Hondo, Akita 0108543, Japan.
• Spine J. 2007 Jul 1;7(4):499-505.

Background Contextcomplete or total en bloc spondylectomy has been recommended for giant cell tumors of the spine. Wide local resection of the fifth lumbar vertebra carries potential risks of major complications because of its anatomical features. Only nine cases of the giant cell tumors involving the fifth lumbar vertebra have been reported in the literature.Purposeto present two cases of giant cell tumor of the fifth lumbar vertebra treated by single-stage combined anterior and posterior tumor resection over 7 years of follow-up.Study DesignCase report and a review of literature.MethodsA 33-year-old female and a 20-year-old female, each diagnosed with giant cell tumor of fifth lumbar vertebra, underwent single-stage tumor resection through a combined posterior and retroperitoneal anterior approach.ResultsThe resection of the fifth lumbar vertebra was completed in the first case without major perioperative complications. In the second case, massive bleeding during the anterior procedure for resection of the vertebral body interrupted the total resection of the tumor, resulting in possible residual tumor which required adjuvant radiotherapy. The patients recovered both clinically and neurologically after the operation. Spinal reconstruction was maintained, and no recurrence of the tumor was evident at the 7-year and 8-year follow-up, respectively.ConclusionThere was no recurrence of the tumor after the combined single-stage anterior and posterior tumor resection and adjuvant radiotherapy for the second case for over 7 years follow-up. However, complete resection of the vertebra and tumor at the fifth lumbar vertebra is still challenging to accomplish.

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