CASE 17: Kidney cancer metastasis to the lumbar spine

• 57-year-old male patient
• History of treatment for kidney (renal cell) cancer. • Presented with complaints of difficulty walking due to lower back pain that worsened over time and woke her from sleep at night.
• Due to fractures and kyphosis deformity caused by metastasis in the first and second lumbar vertebrae, the tumorous vertebra was removed, the resulting cavity was filled with bone cement, and strengthened with cemented screws (posterior instrumentation) as the patient had general bone weakness/osteoporosis. • The patient's pain was significantly reduced, and they were able to walk safely.
• Two weeks after surgery, the patient's wound had healed and the stitches removed, and they were referred to radiation oncology for radiotherapy.

Before the surgery: MRI shows metastatic tumors and kyphosis deformity in L1 and L2 vertebrae, and CT scan shows fracture and instability.

Post-Surgery: The X-ray shows cement application to replace the removed tumor and fractured portion of the spine, correction of kyphosis deformity, and reinforcement of the upper and lower vertebrae with cemented screws.