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Home Conference KNS 2019 Total spondylectomy for solitary bone plasmacytoma of the L4 lumbar spine

Total spondylectomy for solitary bone plasmacytoma of the L4 lumbar spine

Prof. Sunguk Kuh Gangnam Severance Hospital | Republic of Korea Speciality : Neurosurgery

20:01

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Total corpectomy is useful surgical method for spinal tumor, spondylodiscitis, and comminuted vertebral body fractures needs anterior column reconstruction as a single or two-staged procedure.

Unique anatomy of the L4 lumbar vertebra ;

1. proximity of aorta, inferior vena cava,
and iliac veins makes a challenge for total enbloc
spondylectomy lumbar region

2. Even in anterior approach, aortic bifurcation
around L4 and common osteoarthritic bony sclerosis
makes L4 corpectomy a technically challenging

3. lumbar nerve roots may be intentionally
sacrificed to ensure adequate margins
in posterior only approach

CASE 1.

A 69 year-old woman
Past history ; L1 compression fracture after rolling down injury 5 months ago

Kyphoplasty with calcium phosphate
(Zectos) on L1 compressed vertebra at local Hospital

Pain and weakness aggravated due to spinal cord compression

CASE 2.

C.C: Lt. leg weakness & Lt. leg pain (VAS 8, L4, L5 Dermatome)
D: 2 month

59 years old male patient complain Lt. leg pain and tingling sensation since 2 months ago
and recently Lt. leg motor weakness developed and aggravated.

N. Ex)
Motor Rt. leg Lt. leg
   Hip Flexion / Extension V / V II / II
   Knee Flexion / Extension V / V III / IV+
   Ankle Dorsi Flexion / Plantar Flexion V / IV+ 0 / I
   Big toe Dorsi Flexion / Plantar Flexion II / IV+ 0 / I

Medical Devices

■ Microscope : N/A

■ Navigation : N/A

■ Surgical Drill : N/A

■ 3D Camera : 3DMedivision M-Flix

■ 3D Recorder : 3DMedivision R-Flix

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