Neurosurgery 96:494–504, 2025
• Study Objective: Investigate postoperative outcomes of spinal chordoma surgery over 20 years.
• Patient Cohort: 101 patients, average follow-up of 6.0 ± 4.2 years.
• Recurrence and Mortality: 24.8% recurrence, 9.9% mortality.
• Risk Factors: Tumors ≥100 cm³ and mobile spine chordomas linked to worse outcomes.
• Neoadjuvant Radiotherapy: Associated with improved local recurrence-free survival (LRFS).
• Age Impact: Patients ≥65 years at surgery have a higher mortality risk.
• Surgical Outcomes: Pain decreased post-surgery, sensory deficits and weakness remained static.
• Functional Outcomes: 39% of patients pain-free long-term, no significant change in sensory deficits.
• Surgical Complications: 65.3% experienced complications; 32.7% required reoperation.
• Radiotherapy Advances: Newer modalities like stereotactic photon therapy show promising LRFS rates.
• Study Design: Retrospective review from 2003-2023 at a quaternary spinal oncology center.
• Data Analysis: Multivariable Cox regression used to identify predictors of LRFS and OS.
• Surgical Approach: Enneking Appropriate surgery preferred for better outcomes.
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