Asian Spine J.  2015 Dec;9(6):962-965. 10.4184/asj.2015.9.6.962.

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

• Lee CK
• Chan CY
• Kwan MK

• KMID: 2131122
• DOI: http://doi.org/10.4184/asj.2015.9.6.962

Abstract

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.

Keyword

Ultra long construct; Minimally invasive stabilization; Percutaneous; Spinal metastasis; Spinal cord compression

MeSH Terms

Decompression
Female
Fractures, Spontaneous
Humans
Lung Neoplasms
Middle Aged
Neoplasm Metastasis*
Neurology
Radiotherapy
Spinal Cord Compression
Spine