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25-FEBRUARY-2002 NUMAN FAYEQ ABDALLA 55 YEARS RENAL CELL
CARCINOMA MTS TO L3 BODY WITH SEVERE COMPRESSION.
Anamnesis
The patient came to the clinic 17-March-2003
complaining of LBP for 4 months with inability
to walk the last month. He was operated for
renal cell carcinoma 01-February-2002 with right
nephrectomy. MRI lumbar spine done 15-March-2003
showing destruction of L3 with tumor invading
the bone and paravertebral column.
On examination SLRS was 0 degree both sides.
There is weak dorsi and planterflexion left foot
and abduction and adduction of the hips. He was
advised to to treated by oncologists and he
underwent radiation and came
09-February-2004 with further deterioration of
motor function both lower limbs.
Skeletonization of L1.2.3.4.5
was performed. Laminectomy of L3 with removal of
the lateral masses and preserving the L4 roots
both sides, corporectomy of L3 was performed
using drill and pituitaries. No trail was paid
to explore the paravertebral area, since the
aorta and vena cava were involved. After
achieving practical resection of L3 with
adjacent disci, bone cement was full filled the
cavity trying to avoid the thermal effect of the
process at the neural tissues. Using Luque
rectangle and 8 sublaminar wires. fusion of
L1,2,4,5 was achieved. Routine closure of the
wound. Smooth postoperative recovery
FOLLOW UP
The patient for unknown reasons did not show up
in the clinic.
Comments
This case only palliative to decompress the
neural elements and preserve stability.
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Notice: Head injuries and very urgent surgeries are also
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