L 3 Metastatic tumor from adenocarcinoma of Prostate

A 65-year-old gentleman on treatment for adenocarcinoma of Prostate complained of back pain and shooting sensation in B/l lower limbs and perineal area

MRI revealed a tumor in L3 vertebra pressing on the Cauda equina (Lumbar nerve roots)

CT scan done to assess the bony structure showed complete destruction of the L3 vertebra

Surgery was done in 2 stages

1. L3 Corpectomy and reconstruction through a lateral retroperitoneal approach through the flank

2. Posterior percutaneous pedicle screw instrumentation with cement augmented screws.

The patient underwent radiotherapy and chemotherapy 10 days after the surgery

The retroperitoneal approach does not involve any muscle trauma hence wound healing is better which is important for patients undergoing post-op radiation therapy