Ultra Long Construct Minimally Invasive Spinal Stabilization Using Percutaneous Pedicle Screws in the Treatment of Symptomatic Multicentric Spinal Metastasis

Managing multiple level spinal metastases is challenging. We report the case of a 58-year-old female with advanced lung cancer who presented with multiple pathological fractures of the thoracic spine (T5, T6, T7, and T8 vertebrae). She was treated with palliative radiotherapy. Her resting pain impro...

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Bibliographic Details
Published in:Asian spine journal 2015, 9(6), , pp.962-965
Main Authors: Lee, Chee Kean, Chan, Chris Yin Wei, Kwan, Mun Keong
Format: Article
Language:English
Subjects:
Back pain
Cancer
Decompression
Epidural
Fractures
Lung cancer
Magnetic resonance imaging
Medical prognosis
Metastases
Metastasis
Minimally invasive stabilization
Morbidity
Pain
Patients
Percutaneous
Radiation therapy
Spinal cord
Spinal cord compression
Spinal metastasis
Spine (thoracic)
Surgery
Technical Note
Ultra long construct
Vertebrae
정형외과학
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Summary:Managing multiple level spinal metastases is challenging. We report the case of a 58-year-old female with advanced lung cancer who presented with multiple pathological fractures of the thoracic spine (T5, T6, T7, and T8 vertebrae). She was treated with palliative radiotherapy. Her resting pain improved, but the instability pain persisted. One month later, she had a trivial fall leading to a pathological fracture of the L2 vertebra with cauda equine syndrome. The patient was treated surgically with minimally invasive decompression of the L2 and with percutaneous instrumented stabilization using an ultra-long construct from T3 to L5 (15 spinal levels), spanning the previously radiated zone and the decompression site. Postoperatively, she had significant improvements in pain and neurology. There were no surgical complications. Ultra long construct minimally invasive spinal stabilization is the ideal approach for symptomatic multicentric spinal metastasis with poor prognostic scores. Using this technique, the goals of spinal stabilization and direct neural decompression can be achieved with minimal morbidity.
ISSN:1976-1902
1976-7846
DOI:10.4184/asj.2015.9.6.962