One-Stage Posterior Only Corpectomy AndFusionInTheTreatment Of Metastatic Spinal Disease WithoutNeurologic Deficit: A Case Presentation

Abstract

Introduction The treatment of lumbar metastatic burst fractures without neurologic deficit can be approached using a one-stageposterior-only corpectomy and fusion technique. This technique involves the removal of the af ected vertebral bodyand its replacement with an expandable titanium cage to provide stability and promote fusion. Case Report We describe our initial experience with the case of a 36-year-old female who presented with spinal nervecompression symptoms with radiological features of a solitary metastatic disease of the second lumbar vertebraewith a background history of missed unilateral breast tumour. She had a one-staged L2 posterior corpectomy, insertion of an expandable cage and stabilization with pedicle screws and rods. She subsequently did well withnoneurological deficit. Subsequently, she had a full assessment for breast cancer which revealed a left breast malignant tumour and had a radical mastectomy done and followed up with chemotherapy. Discussion Lumber corpectomy combines a posterior approach for instrumentation with an anterior approach for corpectomy and reconstruction of the anterior column. This combined approach is usually associated with high morbidity, long operative time, more blood loss, long hospital stay, protracted rehabilitation period and an access surgeon. In our case, a single approach was done to achieve posterior rigid stabilization, 360° neural decompression, and anterior column reconstruction without exposing the patient to the morbidity associated with the combined approach or the possible vascular complication of an anterior surgery. Conclusion This case shows that a one-stage posterior only corpectomy and fusion can be done safely with good outcome in a poor resource setting