Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7944
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
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. Per
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.
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.
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.