En Bloc Spondylectomy for T11 Metastasis of Nasal Adenocarcinoma: A Case Report.

En bloc spondylectomy resection (EBR) has emerged as a potential option for achieving tumor-free margins and enhancing long-term outcomes in select cases of solitary spinal metastases, though the role of this treatment in metastatic spine disease remains debated. We present the case of a 49-year-old female with a prior history of adenoid cystic carcinoma of the nose who developed back pain two years later. Positron emission tomography-computed tomography (PET-CT) revealed a solitary T11 lesion, and a CT-guided biopsy confirmed metastasis. After meticulous surgical planning guided by the Weinstein-Boriani-Biagini (WBB) classification, an EBR of T11 was performed using a single posterior approach involving an ultrasonic bone scalpel, three-dimensional CT navigation, and intraoperative neuro-monitoring, followed by posterior stabilization and interbody reconstruction. The postoperative course was uneventful, and, at the 52-month follow-up, the patient remained neurologically intact with no local or systemic recurrence. This case underscores the significance of precise preoperative assessment and planning for achieving successful oncological and functional outcomes. Although technically demanding, EBR provides excellent local tumor control and durable results in carefully selected patients with solitary spinal metastases. The long-term disease-free survival in our patient highlights the potential value of this treatment for comprehensive metastatic spine management. Continued research and multicenter collaboration are necessary to standardize the criteria for patient selection, refine the surgical techniques, and establish evidence-based guidelines for the use of EBR to treat metastatic spinal tumors.