Abstract
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.
Absence of a positive outcome bias in randomized controlled trials of minimally invasive surgical techniques
