Minimally invasive surgical decompression for lumbar spinal metastases
This 71-year-old male presented to the ER with new increasingly severe back and lower extremity pain concomitant with his preexisting lower extremity motor deficits that had persisted for roughly 3 months prior and left him wheelchair bound. His past medical history was significant for metastatic castration-resistant prostate cancer diagnosed roughly 20 years prior. He was status post several operations for spinal metastatic disease including decompression of T5-T11 epidural tumor involvement, and a T8 transpedicular corpectomy with T5 to T11 instrumentation for pathologic burst fracture. Imaging of his lumbar spine demonstrated L1-L2 vertebral body metastasis with bilateral L2 foraminal compression []. Systemically, patient had pulmonary edema secondary to pulmonary metastatic disease. Oncology estimated his survival to be less than 6 months.\nA right-sided tubular MIS decompression at L1-2 was performed. Postoperatively his functional status improved from 2/5 to 4+/5 strength in his lower extremities, most notably in his dorsal and plantar flexors. Postoperative imaging demonstrated decompression of involved area [].\nHe maintained this functional increase and had significant decrease in radicular pain and sensory loss [], necessitating much less analgesics. The patient entered neuro-rehabilitation but succumbed to his disease 4 months later.