CASE 30: Giant Cell Bone Tumor Located in the Second Lumbar Vertebra

• 49-year-old female patient
• The patient presented with complaints of lower back pain that had been present for about a month, along with burning and tingling in the left thigh.
• He has a history of surgery for lumbar discopathy (herniated disc) in 2018.
• Tenderness on deep palpation in the lumbar region, numbness in the anterior and lateral aspects of the left thigh.
• The patient underwent closed needle biopsy under CT guidance, and the pathology result revealed a giant cell bone tumor.
• No lung metastases were detected in the scans.
• First, a total laminectomy, nerve root decompression, and instrumentation were performed via a posterior approach, followed by partial corpectomy and elevator cage placement via an anterior approach, along with instrumentation of one vertebra above and one vertebra below.
• The patient experienced no problems during or after the surgery and was discharged walking without pain.

Before the surgery: X-ray shows a lytic lesion in the L3 vertebra.

Before the surgery: PET-CT shows increased activity and bone damage.

Before the surgery: The MRI shows a large tumor tissue that has spread beyond the bone, invaded the muscle, and is causing nerve compression.

During the operation: The image shows posterior laminectomy and root release followed by anterior corpectomy, elevator cage placement, and instrumentation.

Post-surgery: The X-ray shows total laminectomy, posterior instrumentation, anterior corpectomy, elevator cage placement, and instrumentation.