Minimally Invasive Tubular Transpedicular Partial Corpectomy and Percutaneous Segmental Posterior Fixation With a Combined Titanium and Carbon Fiber Construct: 2-Dimensional Operative Video
Travis S. CreveCoeur, MD1,2, Chiemela Izima, BA1, Damian E. Teasley, BS1, Deborah Boyett, MD1, Grace K. Mandigo, MD1, Andrew K. Chan, MD1,2
1Department of Neurological Surgery, Columbia University Irving Medical Center, New York, New York, USA; 2The Och Spine Hospital at NewYork Presbyterian, New York, New York, USA
Correspondence: Andrew K. Chan, MD, Department of Neurological Surgery, Columbia University Irving Medical Center, The Och Spine Hospital at NewYork-Presbyterian, 5141 Broadway 3FW, New York, NY 10034, USA. Email: akc2136@columbia.edu
Received, June 18, 2025; Accepted, November 05, 2025; Published Online, January 15, 2026.
Operative Neurosurgery 00:1-2, 2026
@ Congress of Neurological Surgeons 2026. All rights reserved.
https://doi.org/10.1227/ons.0000000000001899
Spinal metastases represent a frequent oncological complication portending significant morbidity and mortality.1,2 Conventional open surgical approaches are characterized by paraspinal muscle devitalization, blood loss, wound complications, and protracted delays to adjuvant radiation therapy and functional restoration. Despite emerging ev- idence supporting minimally invasive spinal oncology techniques, widespread adoption remains limited.3-7 We present the first documented video demonstration of a minimally invasive transpedicular partial corpectomy using a unilateral tubular retractor system with concurrent posterior instrumentation using a hybrid titanium-carbon fiber construct. A young female patient with high-grade metastatic adrenocortical carcinoma, 5 years after primary surgical resection, developed progressive, medically refractory radicular pain and dysesthesias over 1 month. Advanced imaging revealed a pathologic L2 vertebral body fracture with significant thecal sac compression and severe right-sided L2-L3 foraminal stenosis. Contrast-enhanced T1-weighted sequences demonstrated epidural tumor extension with unilateral posterior element involvement. Given the characteristic hypervascularity of adrenocortical metastases,7,8 prophylactic endo- vascular embolization of the right L1 and bilateral L2 segmental arteries was performed to optimize hemostatic control. Immediately and at 14-month follow-up, complete symptom resolution was achieved with successful completion of adjuvant radiation therapy without perioperative complications. This case demonstrates the technical feasibility and clinical efficacy of advanced minimally invasive approaches for complex spinal oncological reconstructions. This surgical technique expands the therapeutic armamentarium for spinal metastatic disease management while potentially re- ducing perioperative morbidity and optimizing oncological care pathways. The patient consented to the procedure following discussion of alternatives and risks. Institutional Review Board approval was not required. Informed consent was obtained for publication of video/images.
KEY WORDS: Corpectomy, Adrenocortical carcinoma, Spinal metastases, Spinal oncology, Minimally invasive spine surgery, Separation surgery
Watch now at http://dx.doi.org/10.1227/ons.0000000000001899
Funding
This study did not receive any funding or financial support.
Disclosures
Dr Chan receives personal fees from Alphatec Spine, Isto Biologics, Carlsmed, and SpineArt, and research grants from the Cervical Spine Research Society. The other authors have no personal, financial, or
institutional interest in any of the drugs, materials, or devices described in this article.
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Acknowledgments
Author contributions: Operative procedure: Andrew K. Chan, Travis S. CreveCoeur, Deborah Boyett, Grace K. Mandigo. Video creation, literature re- view, and abstract writing: Travis S. CreveCoeur, Chiemela Izima, Damian E. Teasley, Andrew K. Chan. Narration: Andrew K. Chan.