Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2022; 10(22): 7944-7949
Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7944
Percutaneous transforaminal endoscopic decompression combined with percutaneous vertebroplasty in treatment of lumbar vertebral body metastases: A case report
Qiang Ran, Tong Li, Zhi-Ping Kuang, Xiao-Hong Guo
Qiang Ran, Department of Orthopaedics, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400010, China,
Qiang Ran, Tong Li, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610000, Sichuan Province, China
Zhi-Ping Kuang, Department of Orthopaedics, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400000, China
Xiao-Hong Guo, Department of Pharmacy, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400000, China
Author contributions: Ran Q conceived the central idea, analyzed clinical data and wrote the initial draft; All authors participated in clinical diagnosis and revised the manuscript.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Hong Guo, PhD, Pharmacist, Department of Pharmacy, Chongqing Hospital of Traditional Chinese Medicine, No. 6 Panxi Seventh Branch Road, Jiangbei District, Chongqing 400000, China. ranqiang129600@163.com
Received: November 22, 2021
Peer-review started: November 22, 2021
First decision: May 11, 2022
Revised: May 19, 2022
Accepted: June 21, 2022
Article in press: June 21, 2022
Published online: August 6, 2022
Processing time: 241 Days and 16.2 Hours
Abstract
BACKGROUND

Percutaneous endoscopic lumbar discectomy (PTED) is a procedure that is commonly used to treat lumbar disc herniation and spinal stenosis. Despite its less invasiveness, this surgery is rarely used to treat spinal metastases. Percutaneous vertebroplasty (PVP) has been utilized to treat lumbar vertebral body metastases but it has not proven useful in treating sciatic patients.

CASE SUMMARY

A 68-year-old woman presented with low back pain and radicular symptoms. She couldn't straighten her legs because of severe pain. Computed tomography (CT) showed a mass lesion in the lung and bone destruction in the L4 vertebrae. The biopsy of the lung lesion revealed adenocarcinoma and the biopsy for L4 vertebrae revealed metastatic adenocarcinoma. PTED paired with PVP was performed on the patient due to the patient's poor overall physical state and short survival time. Transcatheter arterial embolization of vertebral tumors was performed before surgical resection to reduce excessive blood loss during the operation. The incision was scaled up with the TESSY technology. The pain was obviously relieved following the operation and no serious complications occurred. Postoperative CT showed that the decompression around the nerve root was successful, polymethyl methacrylate filling was satisfactory and the tumor tissue around the nerve root was obviously removed. During the 1-year follow-up period, the patient was in a stable condition.

CONCLUSION

PTED in combination with PVP is an effective and safe treatment for Lumbar single-level Spinal Column metastases with radicular symptoms. Because of the small sample size and short follow-up time, the long-term clinical efficacy of this method needs to be further confirmed.

Keywords: Minimally invasive surgery; Nerve root; Percutaneous; Spinal metastases; Transforaminal endoscopic decompression; Case report

Core Tip: Spinal metastatic tumor is a common clinical disease. Because of the poor general condition of patients, minimally invasive treatment is widely used. We present a case of metastatic adenocarcinoma in the L4 vertebrae treated with percutaneous endoscopic lumbar discectomy (PTED) combined with percutaneous vertebroplasty (PVP), with transcatheter arterial embolization of vertebral tumors performed before surgical resection. The therapeutic results were satisfactory. PTED combined with PVP is a safe and effective method for treating Lumbar single-level Spinal Column metastases with radicular symptoms.