Extensive lumbar chordoma and unique reconstructive approach

Chordomas are rare, malignant, low grade, primary bone tumours arising from notochord remnants. They are rarely located in the lumbar spine and consequently, the literature is lacking about the condition. There are very few case reports on the technical aspects of resection of extensive lesions such as our case. Treatment can be potentially curative only if aggressive surgical resection is utilised. We describe a case of an extensive lumbar chordoma, and demonstrate the possibility of performing a staged anterior and posterior total tumour resection with planned transgression in conjunction with an expandable cage, vascularised rib, fibula and latissimus dorsi grafts for the treatment and reconstruction of extensive spinal disease with this condition.