Radical Surgery of Only the Anterior Elements of the Spine at the Posterior Element Fusion Level due to Metastatic Thyroid Cancer

Abstract

Spinal metastasis of differentiated thyroid cancer can have a favorable prognosis if radical surgery is performed. We encountered a case of spinal metastasis involving three anterior vertebral bodies at the posterior element fusion level and successfully achieved adequate stability by radical surgery involving only the anterior elements. A 67-year-old woman who had numbness and muscle weakness in the lower limbs caused by metastatic spinal tumor at the posterior element fusion level of L1-L3 vertebrae was treated with radical surgery of only the anterior element to gain stability. Similar situations may occur in cases involving other malignant tumor metastases or spinal primary tumors. If such a case occurs, this method could be useful in preventing metastasis to the posterior element.

Figure 1

X-ray image of the spine at the first visit. Deformation of L2 vertebral body after posterior fixation surgery.

Figure 2

MRI findings. Brightness changes in the L1, L2, and L3 vertebral bodies and compression of the spinal canal by the tumor at the same level.

Figure 3

CT images. Vertebral arch (T12–L3) after posterior fixation surgery indicated complete bone union and bridge formation.

Figure 4

Uptake for metastases in the posterior element was not observed in PET/CT.

Figure 5

Postoperative CT images. The dashed line shows the approach route. The painted area indicates the excision area.

Figure 6

X-ray image of the spine after surgery.