Board Certified Neurosurgeon Brain & Spine Care 860-889-9035
Mark Hornyak, MDBoard Certified Neurosurgeon
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Spine / Tumor Case

Metastatic tumor to T12

53 year old man presents with mid-lower back pain radiating to the left side of the lower chest and flank Severe after minor fall 2 weeks prior Mild back pain for about 4 months No significant prior medical history

Description

53 year old man presents with mid-lower back pain radiating to the left side of the lower chest and flank
Severe after minor fall 2 weeks prior
Mild back pain for about 4 months
No significant prior medical history

Gallery

Images

Figure 1Sagital (left and axial (right) images from T2 MRI showing abnormally bright signal and expansion of the T12 vertebral body (arrow). The expansion is causing spinal cord compression (the spinal cord is designated by the yellow star(*))
Figure 2Sagital , coronal, and axial (left to right) images from CT scan showing erosion and collapse of the T12 vertebral body. Note the replacement of bone (which is rather bright white) with tumor (which is dark grey), especially well demonstrated in the axial views (right image).
Figure 3Images taken from a PET scan. On the left, the PET information is projected over a CT scan. The PET-active tumor is seen as an orange glow in the T12 vertebral body and in the spinal canal (the bright-orange spots to each side of the spine are the kidneys – a normal finding). On the right is a projection of the PET information in an A-P image from the brain (top) to the legs (bottom). PET-active areas are black. An abnormal spot is seen at T12 (arrow) as well as some other areas.
Figure 4Intraoperative fluoroscopic (x-ray) image showing the placement of the intervertebral cage into the T12 resection cavity in the lateral (left) and A-P (right) planes, spanning from T11 above to L1 below. The cage is attached to an insertion device. Once expended, the device will bear the weight of the patient.
Figure 5Intraoperative video showing the tumor resection cavity. The instrument moving is a suction tube used to remove blood and fluid from the operative field.
Figure 6Intraoperative fluoroscopic (x-ray) image showing the placement of the intervertebral cage into the T12 resection cavity in the lateral (left) and A-P (right) planes, spanning from T11 above to L1 below. The cage is attached to an insertion device. Once expended, the device will bear the weight of the patient.
Figure 7Intraoperative image showing placement of the cage demonstrated in Figure 6. The cage itself is blue in color and can be seen in the resection cavity demonstrated in Figures 5 and 6. The insertion device is seen at the top of the image and a suction tube is at the bottom.
Figure 8Image captured from the intraoperative navigation system. It virtually demonstrates the placement of a screw into the left pedicle of T9.
Figure 9Postop x-ray in the A-P (left) and lateral (right) planes. It shows the intervertebral cage in the T12 corpectomy site as well as the posterior instrumentation – the screws and rods.
Figure 10Postop CT scan in the sagittal, coronal, and axial planes (left-to-right) also demonstrating the surgical instrumentation.

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