• Julien Francisco Zaldivar-Jolissaint, Lukas Bobinski, and John Michael Duff.
• Neurosurgery Service, Centre Hospitalier Universitaire de Grenoble Alpes, La Tronche, France. Electronic address: julienzaldivar@gmail.com.
• World Neurosurg. 2019 Dec 1; 132: 303-308.

BackgroundPrimary Ewing sarcoma of the mobile spine is a rare disease. Its management requires careful surgical planning, because radical, margin-free excision is directly correlated with prognosis. Extensive bone removal in the cervical spine can lead to instability and cause postoperative iatrogenic cervical deformity. Thus, spinal instrumentation plays an important role in restoring postresection spinal stability and improving quality of life.MethodsWe present a novel technique that allows successful removal of a large Ewing sarcoma of the subaxial cervical spine, infiltrating and traversing the posterior bone elements, and extending into the paraspinal muscles. This technique involves radical en bloc resection of posteriorly located cervical tumors via multilevel pediculotomy, with terminal vertebrae pedicle screw reconstruction.ResultsTerminal vertebrae cervical pedicle screw reconstruction allowed wide surgical excision with satisfactory oncologic and mechanical results.ConclusionsThis technique enables 1-stage total tumor resection and stabilization and may be a viable alternative to radical en bloc resection of posteriorly located epidural malignant lesions of the cervical spine in selected cases.Copyright © 2019. Published by Elsevier Inc.

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