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
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
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