Minimally invasive circumferential spinal decompression and stabilization for symptomatic metastatic spine tumor: Technical case report

Objective: Metastatic epidural spinal cord compression is a potentially devastating complication of cancer and is estimated to occur in 5% to 14% of all cancer patients. It is best treated surgically. Minimally invasive spine surgery has the potential benefits of decreased surgical approach-related morbidity, blood loss, hospital stay, and time to mobilization. CLINICAL PRESENTATION: A 36-year-old man presented with worsening back pain and lower extremity weakness. Workup revealed metastatic adenocarcinoma of the lung with spinal cord compression at T4 and T5. Intervention and technique: T4 and T5 vertebrectomy with expandable cage placement and T1-T8 pedicle screw fixation and fusion were performed using minimally invasive surgical techniques. RESULT: The patient improved neurologically and was ambulatory on postoperative day 1. At the 9-month follow-up point, he remained neurologically intact and pain free, and there was no evidence of hardware failure. Conclusion: Minimally invasive surgical circumferential decompression may be a viable option for the treatment of metastatic epidural spinal cord compression.