For unilateral primary tumors, the noninvolved side will often be instrumented.
When postoperative SBRT is considered, the affected vertebras should not be instrumented to facilitate radiotherapy planning and delivery.
If the tumor involves the posterior element bilaterally, then the affected vertebra will not be instrumented.
Most benign primary tumors will be localized in the posterior element with variable extension into the vertebral body.
Every case is unique.
To illustrate the surgical principle of a posterior intralesional resection, including a significant portion of the vertebral body, we will use a T9 tumor located in segments 1–7 of the WBB classification.