56 An 85-year-old man with a history of prostate cancer complained of middle back pain, refractory to pain management. He had a thoracic sensory level, mild weakness of his lower extremities, and no other systemic signs of illness. Magnetic resonance imaging (MRI) of the thoracic spine shows a circumferential compressive lesion at T9 (Figs. 56-1 and 56-2). FIGURE 56-1 Sagittal MRI of the thoracic spine demonstrates a thoracic bony lesion. Metastatic lesion to the spine A transfacet-transpedicular approach was undertaken for decompression, followed by a long arm instrumented fusion (Fig. 56-3). FIGURE 56-2 Axial MRI of the thoracic spine demonstrates the circumferential nature of metastatic lesions to the spine, which can allow a transpedicular approach.
Metastatic Lesion
Presentation
Radiologic Findings
Diagnosis
Treatment
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