Bone Cancer

6 August, 2022

Managing Metastatic Spinal Cord Compression With Vertebral Collapse
This is the story of a 56 yrs old gentleman, suffering from METASTATIC CARCINOMA LIVER. He presented to Orthopedic OPD with complaints of lower back ache with difficulty to walk since 20 days. After clinical and radiological evaluation he was diagnosed with L5 vertebra collapse with neural cord compression.

Fig 1. Pre Operative MRI – L5 Vertebra Collapse

In the given situation, if timely surgical intervention is not done patient can land up in permanent neurological deficits resulting in permanent power loss in the key muscles of walking and daily need activities, hence kick starting a vicious cycle of decreased mobilization – altered bowel habits – bed sores- reduced vital capacity and chest infections and the list goes on and on.

Hence keeping all these things in mind surgical intervention was planned with SURGICAL DECOMPRESSION AND KYPHOPLASTY WITH POSTERIOR STABILIZATION.

Fig 2. Intra Op – Cord Decompression & Posterior Stailization
Fig 3. Intraoperative Bone Cementing Technique

Post operative there is significant relief from pain and over a period of couple of week’s patient recovered from its neurological deficits

Fig 4. Post Operative X-Rays Post Stabilization
FIG 5. Independent Mobilization With Tailor

Patient is able to mobilize independently and perform his daily day to day activities the next day with tailor brace.

Patient is generally discharged on post op day 2 and is fit to start his systemic therapy after 1 week of surgical intervention which is indeed the whole motive of such surgical intervention to make the patient able enough to undergo systemic therapy which is the ideal course for these metastatic patients.

Dr. Himanshu Rohela
Consultant – Orthopaedic Oncology, RGCIRC, Delhi

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