What is the WBB Weinstein Boriani Biagini surgical staging system for spinal tumors

The WBB surgical staging system for spinal tumors attempts to correlate principles of oncologic surgery with the unique anatomy of the spine and to provide a guide for treatment. The vertebra is divided into 12 radiating zones in clockwise order. The spine is also divided into five tissue layers extending from the paravertebral extraosseous area to the dura:

A. Extraosseous soft tissue

B. Intraosseous superficial

C. Intraosseous deep

D. Extraosseous extradural

E. Extraosseous intradural

Based on this classification, three methods for performing en bloc tumor excisions are defined for the thoracic and lumbar lesions: vertebrectomy, sagittal resection, and resection of the posterior arch (Fig. 63-3).

Spinous Process

Superior Articular Facet

Transverse Process —

A. Extraosseous B. Intraosseous C.Intraosseous

Soft Tissue (Superficial) (Deep)

D. Extraosseous E. Extraosseous (Extradural) (Intradural)

Spinous Process

Superior Articular Facet

Transverse Process —

Figure 63-3. WBB (Weinstein, Boriani, Biagini)

Vertebral surgical staging system for primary spine Body tumors. Tumor extent is described by dividing the

A. Extraosseous B. Intraosseous C.Intraosseous

Soft Tissue (Superficial) (Deep)

D. Extraosseous E. Extraosseous (Extradural) (Intradural)

involved vertebra into 12 sections in a clock-face arrangement. Five tissue layers are defined, moving from the superficial paraspinal soft tissue (layer A) to the dural compartment (layer E). The longitudinal extent of the tumor is recorded according to the levels involved. (From Hart RA, Weinstein JN. Primary benign and malignant musculoskeletal tumors. Semin Spine Surg 1995;7:288-303, with permission.)

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