Percutaneous transforaminal endoscopic decompression combined with percutaneous vertebroplasty in treatment of lumbar vertebral body metastases: A case report

Figure 1 Computed tomography and magnetic resonance imaging. A: Sagittal position lumbar magnetic resonance imaging (MRI) showed a huge metastatic mass destroying L4 vertebral body and pedicle and compressing the nerve root; B: Cross-sectional lumbar MRI showed vertebral body and pedicle were damaged; C: L4 vertebral body and pedicle pathological fractured; D: L4 vertebral body and pedicle were damaged.

Figure 2 Histopathological examination. A: Hematoxylin-eosin stained L4 vertebral body biopsy (200 × magnification) showed metastatic adenocarcinoma; B: Hematoxylin-eosin stained L4 vertebral body biopsy (200 × magnification) showed metastatic adenocarcinoma; C: Hematoxylin-eosin stained L4 vertebral body biopsy (400 × magnification) showed metastatic adenocarcinoma.

Figure 3 Intraoperative imaging. A: Preoperative angiography showed that L4 vertebral bodies were abundant and selective arterial embolization was performed; B: The image illustrated sufficient decompression of intervertebral foramen, partial resection of vertebral body and pedicle of vertebral arch, and exposure of polymethyl methacrylate injected into vertebral body.

Figure 4 Postoperative computed tomography. A: Lumbar computed tomography showed that the decompression around the nerve root was successful, the percutaneous vertebroplasty filling was satisfactory; B: The tumor tissue around the nerve root was obviously removed.