Explore the groundbreaking approach of a posterior-only 2-level vertebrectomy and fusion for treating lumbar metastasis in medically complex patients, showcasing a pioneering case that could redefine pain neurosurgery practices.
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Posterior-only 2-level vertebrectomy and fusion in a medically complex patient with lumbar metastasis: illustrative case.
Johnson et al., J Neurosurg Case Lessons 2024
<!– DOI: 10.3171/CASE23646 //–>
https://doi.org/10.3171/CASE23646
This case study highlights a successful surgical intervention for a 68-year-old male with severe lower-back pain and reduced mobility due to a lumbar metastasis from cholangiocarcinoma. The tumor, located at L2-3, measured 4.5 cm by 5.7 cm by 7.0 cm. The patient underwent a 2-level vertebrectomy with the placement of an expandable cage and a T10 to S2 fusion through a posterior-only approach. Post-surgery, the patient experienced significant improvements in mobility and quality of life. This case is significant as it demonstrates the feasibility and potential benefits of a posterior-only approach for lumbar vertebrectomies and fusion in the context of spinal metastases. It underscores the importance of a multidisciplinary approach and thorough patient consultation when considering high-risk palliative surgeries for patients with a limited prognosis. This contributes to the literature by providing evidence that, even in high-risk scenarios, certain surgical interventions can markedly improve patient outcomes.