Percutaneous Endoscopic Interlaminar Decompression of Hypervascular Spinal Metastases

World Neurosurg. 2020 Feb:134:182-186. doi: 10.1016/j.wneu.2019.10.175. Epub 2019 Nov 4.

Abstract

Background: Percutaneous endoscopic surgery is a common technique used for the treatment of disk herniation and spinal stenosis. In this report, we present a patient who underwent percutaneous endoscopic decompression due to spinal metastasis.

Case description: A 72-year-old female patient with a known diagnosis of lung cancer presented to our clinic with a 10-day history of severe pain in the left leg and a 5-day history of muscle weakness in the left thigh. The patient had a history of multiple organ metastasis and multiple spinal metastasis. On neurologic examination, left hip flexion and extension were graded 2/5. Radiologic workup revealed compression on the left L3 nerve root caused by vertebral metastasis. The patient was planned for a percutaneous full-endoscopic interlaminar decompression due to her clinical condition. The tumor surrounding the left L3 nerve root was removed via endoscopic punch, which resulted in rapid relief of her back pain postoperatively. Adjunct physical therapy was recommended after discharge.

Conclusions: Percutaneous full-endoscopic interlaminar decompression can be an alternative minimally invasive treatment option in selected patients with radicular pain and neurologic deficit caused by spinal metastasis.

Keywords: Endoscopy; Interlaminar decompression; Spinal metastases.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery*
  • Aged
  • Cancer Pain / etiology
  • Cancer Pain / surgery*
  • Decompression, Surgical / methods*
  • Embolization, Therapeutic
  • Female
  • Humans
  • Leg
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery
  • Lung Neoplasms / pathology*
  • Neuroendoscopy / methods*
  • Preoperative Care
  • Radiculopathy / diagnostic imaging
  • Radiculopathy / etiology
  • Radiculopathy / surgery*
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / secondary
  • Spinal Neoplasms / surgery*