In:
Neurosurgical Focus, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 7, No. 6 ( 1999-12), p. E5-
Abstract:
The goals of surgery for metastatic disease of the lumbosacral spine are to relieve compression of the thecal sac and nerve roots, to resect malignant tissue, and to create a stable reconstruction of the spine. Reconstruction of the lumbosacral junction, specifically the L-5 vertebral body, is particularly challenging because the biomechanical properties of this level differ from other areas of the spine. A 40-year-old woman with intraductal breast carcinoma that metastasized to the L-5 vertebral body presented with progressive low-back pain, right-sided L-5 radiculopathy, and weakness. Magnetic resonance imaging revealed a pathological fracture of the L-5 vertebral body with compression of the cauda equina. The L-5 posterior arch, both facet joints and pedicles, and the posterior third of the vertebral body were removed via a posterior approach. A pedicle screw fixation system was applied from L-4 to S-1. The patient was repositioned, and a transabdominal approach was used to resect the anterior two thirds of the L-5 body, which was reconstructed using an allograft bone strut. An interference bone screw was placed through the inferior aspect of the allograft and screwed into the body of S-1 to provide stability for the reconstructive graft. The patient's clinical recovery was excellent. She was ambulating without difficulty when seen at 19-month follow-up examination. Complete spondylectomy by using this novel fusion technique was efficacious in the treatment of metastatic disease to the vertebral column.
Type of Medium:
Online Resource
ISSN:
1092-0684
DOI:
10.3171/foc.1999.7.6.6
Language:
Unknown
Publisher:
Journal of Neurosurgery Publishing Group (JNSPG)
Publication Date:
1999
detail.hit.zdb_id:
2026589-X
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