E-Case report
Intradural Tumor Resection
Posterior Instrumented Fusion T4 – T7 Steven M. Spitz, MD
Pre OP
Clinical Case – Intradural Tumor Resection &
Posterior Instrumented Fusion T4 – T7
Dr. Steven M. Spitz
Neurosurgeon
Director of Neurosurgery
Northside Hospital Cherokee
Canton, GA
USA
Patient Information:
74-year-old female patient presents to the neurosurgery office with complaints of bilateral lumbar paraspinal pain with radiation to her right hip that has been present for years and gotten progressively worse.
She rates her pain an 8 on a scale 0-10 on a daily basis and describes the pain as a deep dull ache that can be occasionally sharp. Her legs feel heavy and weak when standing and walking for too long.
She has had epidural steroid injections in lower back, but they do not help the radiating right hip pain. Any position at this point aggrevates her symptoms.
She has been having significant issues with balance that have become progressively worse.
The patient has a history of previous L4-S1 fusion which was done ten years ago.
Diagnoses:
- Intradural extramedullary tumor at level T5-6
- Osteoporosis
- Arthritis
- Asthma
Pre OP MRI and CTs, sagittal and axial views
OR-strategy:
- Open T4 – T6 laminectomy for resection of the intramedullary tumor
- T5 – T6 left transpedicular approach
- Posterior instrumented fusion T4 – T7
Intra OP
Exposure and careful resection of the intradural extramedullary tumor
Neo Pedicle Screw System™, was used to fuse segments T4 – T7
T4: 2 x Ø4.5×35 mm
T5: 1 x Ø4.5×35 mm
T6: 1 x Ø5.0×35 mm
T7: 2 x Ø6.0×40 mm
2 x 90 mm straight titanium rods
Post OP
Post OP radiographs, sagittal and frontal views
Published with the approval of Dr. Steven M. Spitz, MD