Spinal chordomas

Spinal chordomas are a rare group of primary bony tumors of the axial skeleton. Though histologically they are classified as benign tumors, their indolent growth pattern allowing for sizable tumors at presentation and a high rate of recurrence place them into the category of functionally malignant spinal tumors. Histologically, they have unique cellular architecture that are often pathognomonic for their diagnosis. Management and surgical treatments have advanced significantly over the last few years allowing for an increase in progression free survival. Despite all that is known about spinal chordomas, there is much more that needs to be studied and learned. But it remains true that treating a patient with a spinal chordoma requires a multidisciplinary team approach, with neurosurgeons, neurologists, oncologists, radiation therapists and nurses working together. In this chapter, we discuss each of these topics in more detail.