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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
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3D
Prof. Sunguk Kuh Gangnam Severance Hospital | Republic of Korea Speciality : Neurosurgery
20:01

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Published : 2019-11-01  Views : 284 Likes :
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Summary

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
Patient
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

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